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Risk Adjustment Coder

Humana

Conduct quality assurance coding of medical records and ICD-10 diagnosis codes submitted to CMS and other government agencies.

Ensure coding is accurate and properly supported by clinical documentation within the health record.

Review medical records to identify conditions that map to HCCs, apply the appropriate ICD-10 diagnosis codes, and follow state and federal regulations as well as internal policies and guidelines.

This role includes working on special projects, occasional provider outreach, and supporting operational tasks with limited oversight.

Requirements & Qualifications

Required Qualifications

  • One of the following certifications is required: CPC, CPC-A, COC, CIC, CRC, CCA, CCS, or CCS-P
  • Experience working in a goal-oriented, production-driven, and quality-driven environment
  • Ability to 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-4:30 PM Eastern Time
  • Ability to work 40 hours per week, Monday-Friday, with mandatory overtime as needed
  • Must have a confidential work space with no distractions
  • Proficiency with computers, multiple software applications, and digital tools

Preferred Qualifications

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

Competitive benefits package including:

  • Medical, dental, and vision coverage
  • 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

Virginia, US

Employment Type

Full-time

Experience Level

Intermediate Level

Salary Range

$48,300 - $65,900

Remote work allowed

Yes

Posted

1 week ago

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