Remote Risk Adjustment Coder I – QA & Compliance

Humana; United States; On-site; USD 54,000 - 73,000; Full time

Job summary

Humana in the United States is seeking a Risk Adjustment Coding Professional to perform quality assurance audits of medical records and ICD-9/10 codes submitted to CMS and other government agencies. The role involves reviewing coding accuracy and ensuring documentation supports codes.

You will follow state and federal regulations, participate in provider coding education, and apply professional standards to decisions. The work is remote with potential travel up to 5%.

Qualifications

• Certified coder with CPC/CCS/CCA credentials.
• At least 3 years in coding and Risk Adjustment.
• Proficient in Word, PowerPoint, Excel and Access.
• Able to balance multiple high-priority tasks and meet deadlines.
• Strong collaboration and relationship-building skills.

Responsibilities

• Conduct quality assurance audits of medical records and ICD-9/10 codes submitted to CMS and other agencies.
• Ensure coding accuracy is properly supported by clinical documentation.
• Follow state/federal regulations and internal policies while analyzing coding information.
• Participate in provider education programs on coding compliance and standards.

Skills

CPC/CCS/CCA certified coder

Coding and Risk Adjustment experience

Microsoft Office proficiency

multi-task prioritization

collaboration skills

Tools

Microsoft Office

Job description

Humana in the United States is seeking a Risk Adjustment Coding Professional to perform quality assurance audits of medical records and ICD-9/10 codes submitted to CMS and other government agencies. The role involves reviewing coding accuracy and ensuring documentation supports codes.

You will follow state and federal regulations, participate in provider coding education, and apply professional standards to decisions. The work is remote with potential travel up to 5%.