Remote Risk-Adjustment Coding Consultant

CenterWell Senior Primary Care; Orange City (FL); Hybrid; USD 59,300 - 80,300; Full time

Job summary

Humana's IPA Consultative Coding Professional role in Orange City, FL, provides expert coding guidance to IPA affiliates nationwide to improve risk adjustment and value-based care. You will analyze trends, answer questions, and deliver provider education on documentation standards.

You will manage a provider panel, deliver targeted education, monitor coding workflows, and support ongoing education sessions while collaborating with STARS leaders to close gaps.

Qualifications

• 3+ years of risk adjustment medical coding or risk adjustment provider education.
• Must hold CCS, CRC, or CPC certification.
• Willingness to travel within the assigned MSO market or region (Orange City, FL 32763).

Responsibilities

• Be the primary contact for assigned IPA providers for all coding and documentation inquiries and deliver consultative support.
• Conduct quarterly chart reviews to evaluate coding accuracy and risk capture opportunities, and deliver education.
• Support daily operations of internal coding solutions and assist providers in navigating coding workflows.

Skills

Risk adjustment coding

Education

CCS or CRC or CPC certification

Tools

MS Office

Job description

Humana's IPA Consultative Coding Professional role in Orange City, FL, provides expert coding guidance to IPA affiliates nationwide to improve risk adjustment and value-based care. You will analyze trends, answer questions, and deliver provider education on documentation standards.

You will manage a provider panel, deliver targeted education, monitor coding workflows, and support ongoing education sessions while collaborating with STARS leaders to close gaps.