IPA Consultative Coder - North Florida; Orlando

IPA Consultative Coding Professional

The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. As the primary coding and documentation resource for assigned providers, the role ensures accuracy, compliance, and performance in risk adjustment and value‑based care initiatives.

Orange City, FL 32763

• Act as 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 addressing 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.
• 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.
• 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.
• Travel locally within the assigned MSO market or region as required for in‑office provider support.

• 3+ years of experience in risk adjustment medical coding or provider education.
• Intermediate to advanced competency with Microsoft Office programs (Excel, Word, PowerPoint).
• Certified in at least one of the following: CCS, CRC, or CPC.
• Must reside within 50 miles of Orange City, FL 32763 and be able to travel locally.
• Strong communication and interpersonal skills; ability to engage clinicians and team members in high‑pressure situations.
• Positive, collaborative mindset with an ability to foster partnerships across Coding, Audit and Education, PCO, and Humana teams.
• Work style:
  Hybrid/remote with daily commute to assigned clinic(s) and occasional quarterly travel within the market.
• Standard work hours Monday–Friday 8:00 AM–5:00 PM; additional time may be required.

Base salary range: $59,300 – $80,900 per year, with potential bonus incentive plan based on company and/or individual performance.

Humana offers a comprehensive benefits package, including medical, dental, and vision coverage; a 401(k) retirement savings plan; paid time off, company and personal holidays, paid parental and caregiver leave; short‑term and long‑term disability; life insurance; and additional opportunities.

• This role is considered patient‑facing and is part of Humana's Tuberculosis (TB) screening program. Selected candidates will be screened for TB.
• This role is part of Humana's driver safety program and requires a valid state driver's license with personal vehicle liability insurance meeting minimum limits.
• Employees working from home or hybrid must have a minimum internet download speed of 25
  
  Mbps and upload speed of 10
  
  Mbps.

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) is an equal opportunity employer. It does not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. Humana takes affirmative action in accordance with applicable laws and regulations.