Remote Risk Adjustment Records Auditor

Humana, Inc.; Carson City (NV); Remote; USD 43,000 - 56,000; Full time

Benefits offered by this job

Medical insurance

Dental and Vision benefits

401(k) retirement plan

Paid time off

Job summary

Humana, Inc. is seeking a Risk Adjustment Representative 3 to conduct quality assurance audits of medical records and ICD-9/10 codes for CMS and other government agencies. The role requires independent initiative, judgement, and intermediate math skills in a remote setting with travel to CA.

You will manage sites, track records, and collaborate with IPA/Medical Groups, while maintaining schedules and productivity reports. Monday–Friday, 40 hours, with a pay range of $43,000 to $56,200 per year.

Qualifications

• High School Diploma.
• 3 or more years of experience in healthcare environment/managed care (provider office, billing, coding, medical records, etc.).
• Proficiency in Microsoft Office applications: Word, Excel, and PowerPoint.
• Requires a valid state driver’s license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
• Strong written and verbal communication skills.
• Organizational and time management skills.
• Ability to travel up to 20% to provider offices within CA.
• Understanding of IPA.
• Preferred: Medical record terminology, knowledge of contracting.

Responsibilities

• Manage sites assigned and track records received to a specified goal.
• Document progress/calls made daily and complete daily productivity report.
• Research site information and update information internally.
• Collaborate with IPA and Medical Groups, etc.
• Adapt to changes and business needs; support leadership with processes.

Skills

Healthcare experience

MS Office

Strong communication

Time management

Travel up to 20%

Education

High School Diploma

Job description

Humana, Inc. is seeking a Risk Adjustment Representative 3 to conduct quality assurance audits of medical records and ICD-9/10 codes for CMS and other government agencies. The role requires independent initiative, judgement, and intermediate math skills in a remote setting with travel to CA.

You will manage sites, track records, and collaborate with IPA/Medical Groups, while maintaining schedules and productivity reports. Monday–Friday, 40 hours, with a pay range of $43,000 to $56,200 per year.