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Risk Adjustment Coder

Humana

The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The role ensures coding is accurate and properly supported by clinical documentation within the health record.

The position includes reviewing medical records to report conditions that map to HCCs, applying the appropriate ICD-10 diagnosis codes, following state and federal regulations, and supporting special projects as needed. This is a remote role with training provided in a virtual classroom.

Requirements & Qualifications

Required

  • 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)
  • Experience working in a goal-oriented environment that is production and quality driven
  • Must maintain annual continuing education requirements and remain in good standing with AAPC or AHIMA
  • Ability to attend 3 weeks of virtual classroom training, Monday-Friday, 8:00 a.m. to 4:30 p.m. Eastern Time
  • Ability to work 40 hours per week, Monday-Friday, with mandatory overtime as needed
  • Must have a confidential workspace free from distractions
  • Proficiency using relevant technology and multiple software applications

Preferred

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

Humana offers competitive benefits, including medical, dental, and vision coverage, a 401(k) retirement savings plan, paid time off, company and personal holidays, paid parental and caregiver leave, short-term and long-term disability, and life insurance.

Location

Maryland, US

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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