Senior Coding Educator

🔥 20 hours ago

🥔 Idaho, Montana, +3 more states – Remote

🥔 Idaho – Remote 🦬 Montana – Remote 🌲 Oregon – Remote ⛷️ Utah – Remote ☕ Washington – Remote

💵 $71.1k - $97.8k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Work with providers to identify documentation and coding improvement opportunities • Provide guidance on operational and clinical best practices in risk adjustment methodology • Collaborate with market operations, finance and clinical teams to influence provider adoption of best practices • Develop comprehensive understanding of Humana’s risk adjustment programs and implementation resources • Assess provider performance metrics and identify risk adjustment gaps • Develop action plans to close identified gaps using available resources • Analyze performance indicators and prepare formal presentations for providers • Provide actionable solutions to improve documentation and coding accuracy • Implement courses of action affecting risk adjustment deadlines and report progress • Educate providers on the CMS-HCC Risk Adjustment program and chart documentation requirements • Use EMR interoperability solutions, Point of Care Alerts and Supplemental Data to support population health management • Facilitate presentations and train physicians and staff on documentation, billing and ICD-10 coding • Provide feedback on documentation practices and compliance with state and federal regulations • Build partnerships across coding education, medical director, clinical and market operations teams • Track and trend results for leadership and participating groups and recommend improvements • Report to the Risk Adjustment Manager • Travel occasionally to Humana offices for training or meetings

🎯 Requirements

• 5+ years of experience in risk adjustment coding/auditing/education and provider relations/engagement • Certified Professional Coder (CPC) • Prior experience engaging providers in performance improvement programs • In-depth knowledge of risk adjustment KPIs and CMS payment models (V24 and V28) • Prior experience working in a cross-functional team • Expert facilitation and presentation skills, including online delivery • Advanced Microsoft Office skills, including Word, Excel, Outlook and PowerPoint • Advanced knowledge of billing, claims submission and related functions • Ability to manage competing priorities and multiple projects simultaneously • Ability to adapt quickly to change • Preferred: Bachelor’s Degree • Preferred: Certified Risk Adjustment Coder (CRC) • Preferred: Certified Documentation Expert Outpatient (CDEO) • Preferred: Knowledge of EMR systems including Athena, Epic and eCW • Preferred: experience in risk adjustment within a physician practice or provider group • Ability to analyze reports and data to identify improvement opportunities • Home internet with at least 25 Mbps download and 10 Mbps upload speed • Dedicated workspace without ongoing interruptions to protect PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based upon company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Personal wellness and smart healthcare decision support

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