IPA Consultative Coder - Treasure Coast (Okeechobee / Rural Corridor)

CenterWell • Port Saint Lucie, FL

2d • Hybrid

About The Position

The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide, including MSO-contracted independent providers. This role serves as the primary coding and documentation resource for assigned providers, focusing on accuracy, compliance, and performance in risk adjustment and value-based care initiatives. Responsibilities include analyzing trends, triaging and answering questions in real-time, and researching/interpreting coding guidelines and internal business rules. The role involves assigning a panel of up to 30 providers within a defined market or region, delivering ongoing education, supporting coding workflows, and ensuring adherence to organizational documentation and coding standards. Collaboration with STARS leaders and champions to identify and address gaps is also a key function. The IPA Consultative Coding Professional provides medical coding expertise to support IPA-affiliated clinicians to ensure documentation supports accurate diagnostic coding and risk adjustment capture.

Requirements

• 3+ years of risk adjustment Medical Coding or risk adjustment Provider Education
• Intermediate/advanced competency with MS Office based programs (Excel, Word, PowerPoint)
• Must be certified at least one of the following: CCS, CRC, or CPC
• Must reside and be able to travel within the assigned MSO market or region.
• Ability to travel locally for in-office provider support.
• Self-provided internet service with at minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps; wireless, wired cable or DSL connection is suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Valid state driver's license and maintain personal vehicle liability insurance.

Nice To Haves

• Strong communication and interpersonal skills are essential.
• These skills enable effective, clear, and sensitive engagement with clinicians and team members, even in high-pressure or stressful situations.
• They also facilitate presenting, influencing, and building credibility at all levels of the organization.
• Positive, collaborative mindset with an ability to foster partnerships across Coding, Audit and Education, PCO, and Humana teams.

Responsibilities

• Be the primary contact for assigned IPA providers for all coding and documentation-related inquiries.
• Build consultative relationships with providers to support continuous improvement in coding accuracy and documentation practices.
• Deliver targeted education based on provider-specific trends and opportunities identified through chart reviews and coding analytics.
• Conduct quarterly chart reviews for assigned providers to evaluate coding accuracy, documentation integrity, and risk capture opportunities.
• Develop and deliver comprehensive education based on findings, including documentation best practices and coding optimization strategies.
• Identify trends and recurring gaps, and partner with education and leadership teams to address systemic opportunities.
• Support daily operations of internal coding solutions, including Annual Proof of Documentation (APD 2.0) and any future tools.
• Assist providers in navigating coding workflows, resolving issues, and ensuring successful use of coding tools.
• Monitor and support completion of coding activities tied to assigned providers.
• Participate in a daily coder helpdesk (virtual/Zoom-based), providing real-time support to providers within assigned markets.
• Address immediate coding and documentation questions, ensuring accurate guidance.
• Maintain a high level of responsiveness and provider engagement.
• Support HCC outage management through structured reviews of “assessed but not coded” conditions.
• Conduct targeted reviews to identify missed coding opportunities and provide education to improve recapture performance.
• Collaborate with analytics and leadership teams to track and improve performance outcomes.

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• bonus incentive plan

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed