IPA Consultative Coder - Palm Beach (Central Palm Beach

Become a part of our caring community and help us put health first

The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO‑contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value‑based care initiatives. You will analyze trends, triage, and answer questions in real‑time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.

Location:

West Palm Beach 33406

• Be 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 based on 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.

• Support daily operations of internal coding solutions, including Annual Proof of Documentation (APD 2.0) and any future tools implemented based on organizational needs.
• 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.
• Maintain a high level of responsiveness and provider engagement.

• 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.
• Collaborate with analytics and leadership teams to track and improve performance outcomes.

• 3+ years of risk adjustment medical coding or risk adjustment provider education.
• Intermediate/advanced competency with MS Office based programs (Excel, Word, PowerPoint).
• Must be certified in at least one of the following: CCS, CRC, or CPC.
• Must reside and be able to travel within the assigned MSO market or region. West Palm Beach, FL 33406.

• Strong communication and interpersonal skills essential for effective, clear, and sensitive engagement with clinicians and team members, even in high‑pressure situations. Facilitate presenting, influencing, and building credibility at all levels of the organization.
• Positive, collaborative mindset with an ability to foster partnerships across Coding, Audit and Education, PCO, and Humana teams.

• Ability to travel locally for in‑office provider support.
• Standard working hours required; based on market needs.
• Travel may be required based on provider engagement and business needs.

• Hybrid/remote work style.
• Must reside within 50 miles West Palm Beach, FL 33406.
• Hours:
  
  Monday–Friday, 8:00 AM–5:00 PM; additional time may be required.

This role is part of our company's driver safety program and therefore requires an individual to have a valid state driver's license and 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.