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Salary
$59k – $81k per year
Location
Remote (Virginia, North Carolina, South Carolina, Georgia, United States)
Seniority
Middle · 3+ years exp
Employment
Full-Time
Overview
Company
Impact
Profile match
Humana is an American health insurer founded in 1961 that began as a nursing home operator, moved into hospitals, and eventually sold those to concentrate entirely on health benefits. It is one of the largest providers of Medicare Advantage plans in the United States, where private insurers administer government-funded coverage for older Americans, and it also runs CenterWell, a care delivery arm operating primary care clinics, home health services and a pharmacy. Headquartered in Louisville, Kentucky and listed on the New York Stock Exchange, its results are unusually sensitive to Medicare rate decisions and to how quality star ratings are assessed.

Become a part of our caring community

The Medical Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. You will report to the Manager, Medicare Risk Adjustment.

As the Medical Coding Educator 2 you will

  • Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements.
  • Identify educational needs based on reports
  • Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques.
  • Provider onsite education
  • Collaboration with other market provider facing role
  • Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards.
  • Analyze coding audit results and other relevant data to develop data-driven educational materials and interventions.
  • Work with teams to improve documentation, data integrity, and workflow processes

Use your skills to make an impact

Required Qualifications

  • AHIMA or AAPC CPC (Certified Professional Coder) Certification
  • 3 or more years of medical coding education or auditing in a healthcare setting experience
  • Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience interpreting large data sets
  • Demonstrated knowledge of healthcare risk adjustment, including HCC coding and CMS-HCC model version 28. Experience speaking with leadership, webinars public speaking or presentation skills with healthcare providers
  • Live in NC, SC, GA, VA

Preferred Qualifications

  • Bachelor's Degree
  • Value-based care
  • Primary care
  • Medicare Risk Adjustment knowledge
  • CRC -Certified Risk Adjustment Coder
  • Experience working with healthcare providers
  • Microsoft Office applications

Additional Information

Work at home - with travel (up to 5%) to surrounding provider offices: Valid Driver's license and reliable transportation

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.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.$59,300 - $80,900 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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.

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