Conduct quality assurance coding of medical records and ICD-10 diagnosis codes submitted to CMS and other government agencies.
The role ensures coding is accurate and properly supported by clinical documentation within the health record.
- Review medical records to report conditions that map to HCCs by applying appropriate ICD-10 diagnosis codes.
- Follow state and federal regulations, internal policies, and guidelines while analyzing coding information and medical records.
- Work on projects that may include making phone calls to providers.
- Work within broad guidelines with little oversight.
- Demonstrate professionalism, strong work ethic, reliability, and effective written and verbal communication skills.
- Use computers and relevant technology to navigate multiple software applications and perform tasks using digital tools.
- Participate in special projects in addition to daily responsibilities.
- Be available for occasional overtime to support business needs.
Requirements & Qualifications
At least one of the following certifications is required:
- CPC or CPC-A - Certified Professional Coder (AAPC)
- COC - Certified Outpatient Coder (AAPC)
- CIC - Certified Inpatient Coder (AAPC)
- CRC - Certified Risk Coder (AAPC)
- CCA - Certified Coding Associate (AHIMA)
- CCS - Certified Coding Specialist (AHIMA)
- CCS-P - Certified Coding Specialist-Physician Based (AHIMA)
Additional requirements:
- Experience working in a goal-oriented, production- and quality-driven environment.
- Must maintain annual continuing education requirements and remain in good standing with AAPC or AHIMA.
- Must be able to attend a 3-week virtual classroom training, Monday-Friday, 8:00 a.m. to 4:30 p.m. Eastern time.
- Must be able to work 40 hours per week, Monday-Friday, with mandatory overtime as needed.
- Must have a confidential work space without distractions.
- Proficiency with relevant technology and multiple software applications.
Preferred qualifications:
- Microsoft Word and Excel proficiency.
- Risk adjustment experience.
- HCC coding experience.
Benefits & Perks
Humana offers competitive benefits, including:
- Medical, dental, and vision coverage
- 401(k) retirement savings plan
- Paid time off, company holidays, parental leave, and caregiver leave
- Short-term and long-term disability
- Life insurance
Location
Montana, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$48,300 - $65,900
Remote work allowed
Yes
Posted
1 week ago