IPA Consultative Coder - Palm Beach (Central Palm Beach)

CenterWell Senior Primary Care; West Palm Beach (FL); Hybrid; USD 59,300 - 80,900; Full time

Job summary

Humana is seeking an IPA Consultative Coding Professional to provide medical coding expertise and consultative support to Independent Practice Association affiliates nationwide. 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 questions in real time, research correct coding guidelines, and respond to inquiries while mentoring

Qualifications

• 3+ years of risk adjustment medical coding or risk adjustment provider education.
• Intermediate/advanced competency with MS Office programs (Excel, Word, PowerPoint).
• 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 inquiries.
• Build consultative relationships to improve coding accuracy and documentation practices.
• Deliver education based on provider-specific trends identified through chart reviews and coding analytics.
• Conduct quarterly chart reviews to evaluate coding accuracy and risk capture opportunities.
• Develop and deliver education on documentation best practices and coding optimization.
• Identify trends and partner with leadership to address systemic opportunities.

Skills

Risk adjustment coding

MS Office proficiency

Education

CCS/CRC/CPC certification

Tools

Excel

Word

PowerPoint

Job description

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

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 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.

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 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.

Preferred Qualifications

• 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.

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

• 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.

Driving Statement

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.

Work at Home Statement

To ensure Home or Hybrid Home/Office employees can 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.
• 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

40

Pay Range

$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 offer competitive benefits that support whole‑person well‑being. Associate benefits include medical, dental and vision, 401(k) retirement savings plan, paid time off, company and personal holidays, paid parental and caregiver leave, short‑term and long‑term 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 to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.