Risk Adjustment Representative

Humana Inc; Montana; Remote; USD 43,000 - 57,000; Full time

Job summary

A leading healthcare company is seeking a Risk Adjustment Representative to enhance their operational effectiveness. This remote role requires exceptional communication skills and health information expertise to manage audits and interactions with healthcare professionals effectively. Ideal candidates will offer a solid background in healthcare customer service and administrative tasks, contributing to the organization’s mission of improving health outcomes.

Benefits

Competitive benefits package including medical and dental.

401(k) retirement savings plan.

Paid time off and holidays.

Flexible work environment.

Qualifications

• 2+ years in Healthcare customer service/Release of Information.
• 2+ years of Medical Record and/or health information experience.
• Proficient in Microsoft Office Suite.

Responsibilities

• Conduct risk adjustment audits and manage provider locations.
• Interact with various healthcare staff and manage records.
• Travel up to 25% for site visits related to the role.

Skills

Communication

Organizational skills

Analytical skills

Time management

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Risk Adjustment Representative page is loaded

Risk Adjustment Representative

Apply locations Remote Georgia Remote South Carolina time type Full time posted on Posted Yesterday job requisition id R-378760

Become a part of our caring community and help us put health first

Risk Adjustment Representative 3, position is a remote access role working with providers, vendors, projects and record retrieval associates.

The Risk Adjustment Representative 3

• Role is production driven, high paced and requires remarkable communication skills

• Multiple tasks throughout the day, prioritize while staying organized and maintain a professional composure at all times

• Daily activities include working on risk adjustment audits, monitoring and maintaining provider locations, working with copy services, completing medical record retrievals and helping retrieval associates

• Interacts with provider staff; consisting of front desk associates, office managers, nurses, medical record associates as well as individual doctors. Phone calls are not always pleasant, professional composure is key and required for the role

• Travel up to 25% of the time, and will consist of driving to locations close to your home, as well as driving to locations that require overnight travel for up to a week at a time.

• Administrative tasks for retrieval management, as needed

Use your skills to make an impact

Required Qualifications

• Located in GA or SC

• 2 or more years of Healthcare customer service / Release of Information (in past 5 years)

• 2 or more years of Medical Record and/or health information experience

• 2 or more years Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills including ability to learn new computer programs

• Proficient in Microsoft Word and Excel

• Microsoft Outlook- Proficient in calendar managemen

Preferred Qualifications

• Medical Record Retrieval knowledge

• RADV experience Risk adjustment data validation

• Strong written and verbal communication skills; strong analytical, organizational and time management skills

• Administrative, medical administration or provider office experience

• Knowledge and experience in health care environment/managed care

• Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems

Additional information

Department Hours Monday - Friday 7am to 5pm EST

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor.This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

• Satellite, cellular and microwave connection can be used only if approved by leadership

• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

#LI-BB1

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$43,000 - $56,200 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.