IPA Consultative Coder- $5k sign on bonus

CenterWell Senior Primary Care; Virginia Beach (VA); On-site; USD 59,300 - 80,900; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana's IPA Consultative Coding Professional will provide medical coding expertise and act as the primary resource for assigned providers to ensure accurate documentation and risk adjustment capture.

The role includes quarterly reviews, targeted education, and coding workflow support across internal tools, with travel within the defined market. Facilities a hybrid/remote work model, with standard hours and quarterly travel as needed.

Qualifications

• 3+ years of risk adjustment medical coding or risk adjustment provider education.
• Intermediate/advanced competency with MS Office (Excel, Word, PowerPoint).
• Certification in CCS, CRC, or CPC.
• Must reside and be able to travel within the assigned MSO market or region.

Responsibilities

• 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 and risk capture opportunities.
• Develop education on documentation best practices and coding optimization strategies.
• Identify trends and partner with leadership to address systemic opportunities.
• Support daily operations of internal coding solutions including APD 2.0 and future tools.
• 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 providing real‑time guidance to providers within assigned markets.
• Maintain a high level of responsiveness and provider engagement.
• Support HCC outage management through structured reviews and targeted recapture efforts.

Skills

Risk adjustment coding

MS Office

CCS certification

CRC certification

CPC certification

Job description

Become a part of our caring community

We are looking for a consultative coding professional to provide medical coding expertise and support to IPA affiliates nationwide.

The IPA Consultative Coding Professional will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value‑based care initiatives. They will analyze trends, triage, answer questions in real‑time, research and interpret coding guidelines, and respond to inquiries and issues.

Assignment will include a panel of up to 30 providers within a defined market or region. The professional will deliver ongoing education, support coding workflows, and ensure agreement on documentation and coding standards, while collaborating with STARS leaders and champions to identify gaps and deficiencies. They will support IPA‑affiliated clinicians—physicians and advanced practice providers—to ensure documentation supports accurate diagnostic coding and risk adjustment capture.

Relationship Management and Provider Support

• 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.

Quarterly Chart Reviews and Education

• 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.

Coding Tools, Workflow Support, and Operations

• Support daily operations of internal coding solutions—including Annual Proof of Documentation (APD 2.0) and any future tools implemented.
• 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.

IPA Coding Helpdesk Support

• 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.

HCC Outage and Recapture Support

• 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.

Required Qualifications

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

Preferred Qualifications

• Strong communication and interpersonal skills to engage clinicians and team members, even in high‑pressure or stressful situations.
• Positive, collaborative mindset fostering partnerships across coding, audit and education, PCO, and Humana teams.

Additional Information

• 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.

Work Information

Workstyle: Hybrid/remote.

Location: Must reside within 50 miles of Chesapeake, Suffolk, or Virginia Beach, Virginia.

Hours: Monday–Friday, 8:00 AM–5:00 PM; additional time may be required.

Role requires an in‑center presence with daily commute to assigned clinic(s) and occasional quarterly travel within the market to alternative clinic(s) for strategic meetings.

TB Statement

This role is considered patient‑facing and is part of Humana's Tuberculosis (TB) screening program. If selected, you will be required to be screened for TB.

Driving Statement

This role is part of our company’s driver safety program and requires a valid state driver's license and personal vehicle liability insurance. Individuals must carry vehicle insurance in accordance with the state’s minimum required limits.

Work at Home Statement

Self‑provided internet service must meet the following criteria:

• Download speed of at least 25 Mbps and upload speed of at least 10 Mbps; 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 California, Illinois, Montana, or South Dakota will receive a bi‑weekly payment for internet expense.
• Humana will provide telephone equipment appropriate to meet the business requirements.
• Employees must work from a dedicated space free from ongoing interruptions to protect PHI/HIPAA information.

Pay Range

$59,300 – $80,900 per year. This job is eligible for a bonus incentive plan based on company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries offer competitive benefits supporting whole‑person well‑being, including medical, dental, vision, 401(k), paid time off, parental and caregiver leave, disability, life insurance, and more.

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 advance individuals with disability or protected veteran status, based on valid job requirements.