Risk Adjustment Representative

Risk Adjustment Representative 2 page is loaded## Risk Adjustment Representative 2locations:
Remote Kansas - Kansas Citytime type:
Full time posted on:
Posted Todayjob requisition :
R-403657#
** Become a part of our caring community and help us put health first
** The Risk Adjustment Representative 2 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 Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

The Risk Adjustment Representative 2 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. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments.

Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.#
** Use your skills to make an impact
**** Travel Requirements**
* ** Must
* * reside in the Kansas City Metro area.
* ** Must
* * be able to travel up to 70% of the time at peak season including some overnight travel.
* ** Must
* * have reliable transportation.
** Required Qualifications
*** Minimum 1 or more years of customer service experience.
* Experience with Medical records.
* Experience with Medical terminology.
* Proficiency in Microsoft Office applications:
Word and Excel
* Knowledge and experience in health care environment/managed care (provider office, billing, coding, release of information, etc.)
* This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.
* Demonstrated ability to articulate ideas effectively in both written and oral forms.
* Organizational and time management skills.
* Must be passionate about contributing to an organization focused on continuously improving consumer experience.
** Preferred Qualifications
*** Familiarity with ICD-9/10 coding
** Additional Information
**** Work-At-Home Requirements:
*** At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
* Satellite, cellular and microwave connection can be used only if approved by leadership.
* Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
* Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
* Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
** Scheduled Weekly Hours
** 40
* * Pay Range
** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$40,000 - $52,300 per year
** Description of Benefits
** Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that…