Risk Adjustment Coding Professional 1 (CPC) - Remote/Work at Home - Nationwide

Description

The Risk Adjustment Coding Professional 1 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 1 work assignments are often straightforward and of moderate complexity.

Responsibilities

The Risk Adjustment Coding Professional 1 ensures coding and auditing 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 and auditing information and medical records. May participate in provider education programs on coding and auditing 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.

Required Qualifications

• 3 years of Job related experiences.
• Proficiency in all Microsoft Office Programs including Word, PowerPoint, Excel, Access, etc.
• Prior coding experience.
• CPC (Certified Professional Coder) Certification required.
• COVID VACCINATION: Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
• WORK AT HOME Requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Qualifications

• Bachelor's degree or equivalent.
• Strong analytical, organizational and time management skills.
• Strong knowledge of ICD-10 coding/managed care.

Additional Information

• Schedule: Monday to Friday, 8 hour shift between 6:00 AM and 5:00 PM Eastern Tim. Overtime as per business needs.
• Travel: May be authorized travel to attend Coding conference and/or a team building event, but not more than 5%.

• Training: 5 business days and will be virtual

• Work Location (Address): Home (Remote/WAH) Nationwide

Scheduled Weekly Hours

40