HumanaHU

Risk Adjustment Coding Professional

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky, offering a wide range of insurance products and health and wellness services.

Humana

Employee count: 5000+

Salary: 54k-73k USD

United States only

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

The Risk Adjustment Coding Professional 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 Coding Professional work assignments are often straightforward and of moderate complexity.

The Risk Adjustment Coding Professional 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. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.


Use your skills to make an impact

Required Qualifications

  • Certified Coder Certification - CPC, CCS or CCA.
  • 3 years of related coding and Risk Adjustment experience.
  • Proficiency in all Microsoft Office Programs including Word, PowerPoint, Excel, Access, etc.
  • Demonstrated ability to balance multiple high priority tasks and meet internal and external deadlines.
  • Strong collaboration and relationship building skills.

Preferred Qualifications

  • Prior audit experience
  • Strong analytical, organizational and time management skills
  • Strong knowledge of ICD-10 coding/managed care

Additional Information

Mandatory overtime may be required.

  • Hours: Must be willing to work an 8-hour shift, Monday - Friday. Start time can be on the hour or half hour between 6:00AM and 8:30AM Eastern Standard Time.
  • Travel: May be authorized travel to attend Coding conference and or team building event, but not more than 5%.

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

Work-At-Home Requirements:

  • WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
  • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
  • Satellite and Wireless Internet service is NOT allowed for this role.
  • 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.$53,700 - $72,600 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.Application Deadline: 07-03-2025


About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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.

About the job

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Posted on

Job type

Full Time

Experience level

Mid-level

Salary

Salary: 54k-73k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Humana

Learn more about Humana and their company culture.

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Humana Inc. is dedicated to improving the health and well-being of the millions of people it serves. Our customers often navigate complex healthcare systems and face challenges in accessing affordable, high-quality care. That's why we are committed to putting health first, not just for our members, but also for our teammates and the broader communities we impact. We understand that true health encompasses more than just physical well-being; it includes emotional, social, and financial health. Therefore, we strive to offer personalized care from people who genuinely care, listening to our members' needs and creating solutions that help them achieve their best selves. Our approach is rooted in an integrated care delivery model that aims to simplify the healthcare experience, making it easier for individuals and families to get the right care at the right time.

Since our founding in 1961, initially as a nursing home company and later evolving into a leading health insurance provider, Humana has consistently adapted to meet the changing needs of the healthcare landscape. We specialize in government-sponsored programs, with a significant portion of our medical membership stemming from Medicare Advantage, Medicaid, and TRICARE. Beyond traditional insurance, Humana is increasingly focused on providing comprehensive healthcare services, including primary care, at-home care, and pharmacy benefit management through our CenterWell brand. We recognize that many of our customers, particularly seniors, are managing multiple chronic conditions. Our integrated care delivery model, which leverages both high-tech tools like data analytics and personalized, low-tech interactions such as in-home visits, allows us to predict, slow, and sometimes even prevent disease progression. We are deeply invested in the communities we serve, working to address health disparities and improve local health outcomes through initiatives like our Bold Goal, which aims to improve the health of the communities we serve by making it easier for people to achieve their best health.

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Humana hiring Risk Adjustment Coding Professional • Remote (Work from Home) | Himalayas