IPA Medical Coder

Overview

Become a part of our caring community and help us put health first. The Medical Coder extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coder confirms appropriate diagnosis related group (DRG) assignments.

Review and analyze patient medical records to identify accurate ICD-10-CM diagnosis codes, ensuring all relevant conditions affecting patient s care are documented to the highest level of specificity. Validate that documentation supports risk adjustment coding and HCC capture in compliance with regulatory guidelines. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals, and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology.

Works within broad guidelines with little oversight.

• Identify and assign appropriate ICD-10-CM and CPT codes from medical records.
• Review and analyze patient records to ensure documentation supports risk adjustment coding and HCC capture in compliance with regulatory guidelines.
• Confirm DRG assignments.
• Manage and coordinate administrative work with internal teams and external vendors; prioritize daily tasks and monitor progress toward schedules/goals; oversee work of others as needed.
• Respond to or clarify internal requests for medical information.

• Certified medical coder with one of the following certifications: CPC, CPC-A, CPC-H or CPMA from AAPC; or CCA, CCSP, or CCS from AHIMA.
• ICD-10-CM coding knowledge.
• Proficiency with computers, including Microsoft Outlook, Teams, Adobe and Office products. Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

• Bachelor s Degree.
• 5 or more years of experience as a certified medical coder.
• Familiarity with a variety of EMRs/EHRs.
• Direct communication experience with physicians and other healthcare professionals.
• Strong written/verbal communication skills.
• Prior experience in Medicare Risk Adjustment.

• Candidate MUST reside in Georgia or Tennessee.
• Travel:
  This is a hybrid/field position requiring the ability to work remotely with occasional travel to affiliate offices for trainings or meetings. Travel up to 20% as needed.
• Shift: Monday-Friday with hours 7:30am–5:00pm (EST).
• Submit a copy of your resume and your AAPC or AHIMA certification card with expiration date.

• Home internet requirements: minimum 25 Mbps download and 10 Mbps upload; wireless, wired cable or DSL connection recommended.
• Satellite, cellular and microwave connections require leadership approval.
• Employees in CA, IL, MT or SD may receive bi-weekly internet expense payment.
• Humana will provide telephone equipment appropriate to meet business requirements.
• Work from a dedicated space free from 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: $53,100 - $72,500 per year. This range reflects a good faith estimate of starting base pay for full-time employment at the time of posting; the range may be higher or lower based on location and individual qualifications.

Description Of Benefits:
Humana offers competitive benefits including medical, dental and vision, 401(k), paid time off, holidays, volunteer time off, paid parental and caregiver leave, disability and life insurance, and more. About Conviva Senior Primary Care and Center Well:
Conviva provides proactive, preventive care to seniors;
Center Well focuses on whole-person health with a large network of clinicians and services.

Humana is an Equal Opportunity Employer and complies with applicable laws prohibiting discrimination based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It also adheres to affirmative action requirements where applicable.