Remote Risk Adjustment Auditor III | Healthcare Data Quality

Humana; Hawaii; Remote; USD 43,000 - 56,000; Full time

Job summary

Humana is seeking a Risk Adjustment Representative 3 for a remote position. The role audits medical records and ICD-9/10 codes for CMS and others, with independent judgment and advanced admin tasks. Travel up to 20% to provider offices in California may be required.

Hours are 40 per week with a pay range of $43,000 to $56,200 annually. Benefits include medical, dental and vision, 401(k) and paid time off.

Qualifications

• High School Diploma or equivalent.
• 3+ years in a healthcare environment/managed care.
• Proficiency with Word, Excel, and PowerPoint.
• Valid state driver’s license and vehicle liability insurance (100/300/100).
• Strong written and verbal communication skills.
• Excellent organizational and time management skills.
• Willingness to travel up to 20% to provider offices in CA.
• Understanding of IPA.

Responsibilities

• Management of sites assigned and tracking of records received to a specified goal
• Document progress/calls made daily/complete daily productivity report
• Research site information/update information internally
• Collaboration with IPA and Medical Groups, etc...
• Adapt to changes, business purpose
• Back up to leadership with process and procedures

Skills

MS Office

Communication skills

Time management

Adaptability

Attention to detail

Education

High School Diploma

Experience in healthcare/managed care

Tools

Microsoft Word

Excel

PowerPoint

Job description

Humana is seeking a Risk Adjustment Representative 3 for a remote position. The role audits medical records and ICD-9/10 codes for CMS and others, with independent judgment and advanced admin tasks. Travel up to 20% to provider offices in California may be required.

Hours are 40 per week with a pay range of $43,000 to $56,200 annually. Benefits include medical, dental and vision, 401(k) and paid time off.