Provider Risk Adjustment Educator — Remote

Humana Inc; Honolulu (HI); Remote; USD 71,000 - 98,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana Inc. is seeking a Senior Coding Educator to identify opportunities to improve provider documentation and create a tailored education plan for each assigned provider.

You will report to the Manager, Coding Education and lead the risk adjustment strategy for provider groups. You will analyze data to support education sessions on quality of care, documentation, and coding improvements, collaborating with QCS and Network Performance.

Qualifications

• AAPC CPC (Certified Professional Coder) Certification is required.
• 3+ years of risk adjustment provider education experience.
• 3+ years of medical record review knowledge.
• Medicare Risk Adjustment knowledge.
• Familiar with coding guidelines (ICD-9/ICD-10).
• Experience analyzing data to guide process improvements.
• Excel proficiency including formulas and pivot tables.
• Proficiency in PowerPoint with experience presenting to leadership.

Responsibilities

• Create and execute the risk adjustment strategy for provider groups.
• Analyze data and reports and lead educational sessions with providers for quality of care, documentation, and coding improvements.
• Collaborate with relationship owners and Quality and Cost Strategy (QCS).
• Monitor and develop strategy with Network Performance team and the leader.
• Tailor provider group webinars and discussions on MRA topics.
• Create compliant PowerPoint presentations tailored to group strategy.

Skills

CPC Certification

Risk adjustment education

Medical record review

Medicare risk adjustment knowledge

Coding guidelines (ICD-9/ICD-10)

Data analysis

Excel

PowerPoint

Education

Bachelor's degree

Certified Risk Coder (CRC)

Tools

Power BI

Job description

Humana Inc. is seeking a Senior Coding Educator to identify opportunities to improve provider documentation and create a tailored education plan for each assigned provider.

You will report to the Manager, Coding Education and lead the risk adjustment strategy for provider groups. You will analyze data to support education sessions on quality of care, documentation, and coding improvements, collaborating with QCS and Network Performance.