Become a part of Humana’s caring community.
The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes submitted to CMS and other government agencies. This role ensures coding is accurate and supported by clinical documentation in the health record.
The position involves reviewing medical records to identify conditions that map to HCCs, applying appropriate ICD-10 diagnosis codes, following state and federal regulations, and supporting projects that may include provider outreach. The role works within broad guidelines with little oversight and may include occasional overtime.
At least one of the following certifications is required:
- CPC or CPC-A, AAPC
- COC, AAPC
- CIC, AAPC
- CRC, AAPC
- CCA, AHIMA
- CCS, AHIMA
- CCS-P, AHIMA
Additional requirements:
- Experience in a production- and quality-driven environment
- Must maintain annual continuing education requirements and remain in good standing with AAPC or AHIMA
- Ability to attend a 3-week virtual classroom training, Monday-Friday, 8:00 AM to 4:30 PM Eastern Time
- Ability to work 40 hours per week, Monday-Friday, with mandatory overtime as needed
- Must have a confidential, distraction-free workspace
- Proficiency with computers, multiple software applications, and digital tools
- Effective written and verbal communication skills
- Ability to work within own time zone after training
Preferred qualifications:
- Microsoft Word and Excel proficiency
- Risk adjustment experience
- HCC coding experience
Humana offers competitive benefits, including:
- Medical, dental, and vision insurance
- 401(k) retirement savings plan
- Paid time off
- Company and personal holidays
- Paid parental and caregiver leave
- Short-term and long-term disability
- Life insurance
Location
Maine, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$48,300 - $65,900
Remote work allowed
Yes
Posted
1 week ago