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Risk Adjustment Coder

Humana

The Risk Adjustment Coder performs quality assurance coding of medical records and ICD-10 diagnosis codes submitted to CMS and other government agencies. The role ensures coding accuracy and clinical documentation support within the health record.

Key responsibilities include:

  • Review medical records to identify conditions that map to HCCs and apply appropriate ICD-10 diagnosis codes
  • Follow state and federal regulations as well as internal policies and guidelines
  • Contact providers as needed for projects and clarification
  • Work independently within broad guidelines with limited oversight
  • Participate in special projects and support daily operational tasks
  • Complete work from home responsibilities while protecting PHI/HIPAA information
  • Train remotely for the first 3 weeks, then work a 40-hour schedule Monday through Friday in your own time zone
Requirements & Qualifications

Required qualifications:

  • One of the following certifications from AAPC or AHIMA:
    • CPC or CPC-A
    • COC
    • CIC
    • CRC
    • CCA
    • CCS
    • CCS-P
  • Experience in a goal-oriented, production- and quality-driven environment
  • Current standing in good order with AAPC or AHIMA and ability to maintain annual continuing education requirements
  • Ability to attend 3 weeks of virtual classroom training, Monday through Friday, 8:00 a.m. to 4:30 p.m. Eastern Time
  • Ability to work 40 hours per week Monday through Friday, with mandatory overtime as needed
  • Dedicated confidential workspace without distractions
  • Proficiency with computers, multiple software applications, and digital tools

Preferred qualifications:

  • Microsoft Word and Excel proficiency
  • Risk adjustment experience
  • HCC coding experience
Benefits & Perks

Benefits include:

  • Medical, dental, and vision coverage
  • 401(k) retirement savings plan
  • Paid time off and company holidays
  • Paid parental and caregiver leave
  • Short-term and long-term disability
  • Life insurance

Location

N/A

Employment Type

Full-time

Experience Level

Associate

Salary Range

$48,300 - $65,900

Remote work allowed

Yes

Posted

1 week ago

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