Risk Adjustment Coder

** Become a part of our caring community*
* The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.

The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record.

+ Reviews medical records toreport conditions that map toHCCs by reviewing medical record documentation and applying the appropriate ICD-10diagnosis codes.

+ Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records.

+ Works on projects that may include making phone calls to providers.

+ Works within broad guidelines with little oversight.

+ Demonstratesa professional demeanor, strong workethic, andis a reliable team player with apositiveattitude.

+ Utilizes effective written and verbal communication skills. 

+ Demonstrates Proficiency in using computers and relevant technology including the ability to navigate multiple software applications and perform tasks using digital tools.

+ Participatesonspecial projects, in addition to daily responsibilities.

+ Associates maybe required to work mandatory overtime to meet business needs and ensuretimelycompletion of operational tasks.

** Use your skills to make an impact*
* ** Required Qualifications*
* At least one of the certifications from AAPC or AHIMA are required from the list below: 

+ CPCor CPC-A
- Certified Professional Coder (AAPC)

+ COC - Certified Outpatient Coder (AAPC)

+ CIC - Certified Inpatient Coder (AAPC)

+ CRC - Certified Risk Coder (AAPC)

+ CCA - Certified Coding Associate (AHIMA)

+ CCS - Certified Coding Specialist (AHIMA)

+ CCS-P - Certified Coding Specialist-Physician Based (AHIMA)

+ Experience working in a goal-oriented environment that is production and quality driven.

+ Mustmaintainannual continuing education requirements and remain in good standing with the coding credentialing body, AAPC or AHIMA.

+ Must be able to work
40 hoursa week, Monday - Friday, withthe abilityto workmandatoryovertime as needed to support business needs.

+ Must have a confidential work space in order to work effectivelyandindependently without distractions.

+ Proficient using relevant technology including the ability to navigate multiple software applications and perform tasks using digital tools.

** Preferred Qualifications*
* + Proficient in the use of Microsoft Office systems Word and Excel

+ Risk Adjustment Experience

+ HCC Coding experience

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.

$48,300 - $65,900 per year

** Description of Benefits*
* Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Final date to receive applications: 07-03-2026

** About us*
* About Humana:
Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our Center Well healthcare services, we make it easier for the millions of…