Certified Medical Coder for Humana

Some responsibilities include:

Review medical record information to identify all appropriate coding based on CMS HCC categories.
Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
Provide support, education and training related to, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards.
Provide real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS and STARS.
Coordinate with clinical leadership in the development of provider training plans and for active support in the training process.
Organize and schedule periodic training as indicated from chart review results, and/or as requested by medical leadership or CBO management.
Monitor Coding changes to ensure that most current information is available.
Provides coding support to CBO as requested.
Other duties as may be assigned.

Key Competencies:

Builds Trust: Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one’s actions.
Pursues Excellence: Seeks out learning, strives to develop and expand personally, and continuously helps others upgrade their capability to contribute to Humana.
Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints.
Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana’s overall success first

Qualifications

Role Essentials

CPC, CRC.CCS-P Coding Certification
CPC-A with coding experience
18+ months of prior medical coding experience
Strong organization and process management skills
Strong collaboration and relationship building skills
Training and presentation experience
Excellent written verbal and written communication skills
Proficient with Microsoft Word, PowerPoint and Excel
Ability to drive to provider offices and be in the field approximately 75%

Role Desirables

HCC coding experience
Meidcare knowledge
Prior experience in a fast paced insurance or health care setting
Associate or Bachelor’s degree