Consultative Medical Coding Professional

Humana Inc; Nevada (IA); Hybrid; USD 59,000 - 81,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings plan

Paid time off

Disability insurance

Life insurance

Other opportunities

Job summary

Humana Inc. is seeking a remote Medical Coder with strong documentation and coding expertise to serve as the primary liaison for clinicians.

The role focuses on improving documentation quality and partnering with education teams to drive improvement opportunities. Responsibilities include QA on post-visit reviews, overseeing Mergers & Acquisitions documentation handling, and partnering with HEDIS leaders to close gaps.

Qualifications

• 3+ years of technical medical coding experience or similar (including IPA and Offshore coding management).
• RHIA, RHIT, CCS, or CPC Certification.
• Must reside in the Las Vegas, NV area.
• Ability to travel a minimum of 1 week/month to assigned clinics.
• Proficient in MS Office Suite and Zoom/Teams.
• Must be comfortable presenting on camera and with public speaking.

Responsibilities

• You will cultivate relationships with clinicians to serve as the single contact for questions and issues relating to documentation and coding.
• You will identify documentation improvement areas and partner with clinical and coding education to deliver education related to improvement opportunities.
• You will perform Quality Assurance on post-visit reviews.
• You will manage the special handling of Mergers & Acquisitions by performing problem list cleanup and conducting process training on documentation requirements.
• You will collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies.

Skills

Medical coding

Public speaking

MS Office

Travel readiness

Education

RHIA, RHIT, CCS, or CPC Certification

Tools

Optum Encoder

AthenaOne EMR

Job description

Responsibilities

• You will cultivate relationships with clinicians to serve as the single contact for questions and issues relating to documentation and coding.
• You will identify documentation improvement areas and partner with clinical and coding education to deliver education related to improvement opportunities.
• You will perform Quality Assurance on post-visit reviews.
• You will manage the special handling of Mergers & Acquisitions by performing problem list cleanup and conducting process training on documentation requirements.
• You will collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies.

Required Qualifications

• 3+ years of technical Medical Coding experience or similar (including IPA and Offshore coding management).
• RHIA, RHIT, CCS, or CPC Certification.
• Must reside in the Las Vegas, NV area.
• Ability to travel a minimum of 1 week/month to assigned clinics.
• Proficient in MS Office Suite and Zoom/Teams.
• Must be comfortable presenting on camera and with public speaking.

Preferred Qualifications

• Experience with Optum Encoder or AthenaOne EMR.
• Certified Risk Adjustment Coder (CRC) or Certified Documentation Expert Outpatient (CDEO).

Use your skills to make an impact #LI-CM1

Work from 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from 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. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

• medical benefits
• dental benefits
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• many other opportunities

About us

CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well‑being.

About CenterWell, a Humana company

CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer atCenterWell.com.

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.