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The Medical Coder is responsible for extracting clinical information from medical records and assigning accurate codes using ICD-10-CM, CPT, and HCPCS standards. This position utilizes GenAI and advanced coding tools to perform efficient chart reviews, ensure compliance with regulatory guidelines, and optimize documentation for accurate reimbursement.
This position requires advanced analytical capabilities, sound independent judgment, and accountability for complex administrative and operational functions. Responsibilities include managing and manipulating clinical databases, responding to internal inquiries, and providing clarification on medical documentation and coding-related information.
Responsibilities
Code and abstract patient encounters using ICD-10-CM, CPT, and HCPCS.
Leverage GenAI and other advanced tools to streamline chart reviews and coding workflows.
Ensure accurate sequencing of codes in accordance with government and payer regulations.
Review and validate documentation for diagnoses, procedures, and treatment outcomes.
Extract diagnostic and procedural information from clinical documentation.
Provide feedback and education to providers to improve documentation quality.
Respond to internal inquiries regarding medical information.
Maintain confidentiality and comply with HIPAA regulations.
Analyze, enter, and manage clinical data within medical databases.
Coordinate daily priorities and workflows for administrative teams and/or external vendors.
Monitor progress toward schedules and goals to ensure timely and accurate coding.
Use your skills to make an impact
Required Qualifications
Certified medical coder with one of the following credentials:
AAPC: CPC, CPC-A, CPC-H, or CPMA
AHIMA: CCA, CCSP, or CCS
Minimum of two years of experience in a healthcare coding role
Proficiency in ICD-10-CM, CPT, and HCPCS coding standards
Experience with coding software and electronic health record (EHR) systems
Strong organizational and analytical skills
Effective verbal and written communication skills
Ability to work independently with minimal supervision
Commitment to improving consumer experiences in healthcare
Preferred Qualifications
Bachelor’s Degree
Experience with Medicare Risk Adjustment coding
Additional Information
Remote Role
Standard working hours required; 8:00 am - 5:00 pm; Must be able to work within Eastern Time Zone
Work at Home Requirements
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; 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
Scheduled Weekly Hours
40Pay 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.$53,100 - $72,500 per yearDescription 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.Application Deadline: 10-31-2025
About us
About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to 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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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