Risk Adjustment Coding Professional 1

Humana

1d • $53,700 - $72,600 • Remote

About The Position

The Risk Adjustment Coding Professional conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coding Professional work assignments are often straightforward and of moderate complexity. The Risk Adjustment Coding Professional ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. May participate in provider education programs on coding compliance. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

Requirements

• Certified Coder Certification - CPC, CCS or CCA.
• 3 years of related coding and Risk Adjustment experience.
• Proficiency in all Microsoft Office Programs including Word, PowerPoint, Excel, Access, etc.
• Demonstrated ability to balance multiple high priority tasks and meet internal and external deadlines.
• Strong collaboration and relationship building skills.

Nice To Haves

• Prior audit experience
• Strong analytical, organizational and time management skills
• Strong knowledge of ICD-10 coding/managed care

Responsibilities

• Conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes submitted to CMS and other government agencies.
• Ensures coding is accurate and properly supported by clinical documentation.
• Follows state and federal regulations, and internal policies and guidelines.
• Analyzes coding information and medical records.
• May participate in provider education programs on coding compliance.

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

What This Job Offers

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