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Consultative Coding Manager

Roles & Responsibilities

  • Bachelor's Degree or 6+ years of technical experience
  • 2+ years of management experience
  • CPC (Certified Professional Coder) Certification
  • RHIA, RHIT, or CCS Certification

Requirements:

  • Extracts clinical information from medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records following guidelines and procedures
  • Confirms DRG assignments and analyzes, enters, and manipulates databases; responds to internal requests for medical information
  • Makes decisions related to resources, approach, and tactical operations for projects within own departmental area; conducts cross-department collaboration and area meetings
  • Maintains frequent contact with other managers across the department to coordinate efforts and ensure alignment with organizational goals

Job description

Become a part of our caring community
 

The Consultative Coding Manager 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 Consultative Coding Manager works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.

You will confirm appropriate diagnosis related group (DRG) assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.


Use your skills to make an impact
 

Required Qualifications

  • Bachelor's Degree or 6 plus years of technical experience
  • 2 or more years of management experience
  • CPC (Certified Professional Coder) Certification
  • RHIA, RHIT, CCS Certification
  • MS-DRG auditing or APR auditing experience
  • Acute in-patient and/or outpatient coding experience
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Athena EMR systems experience

Additional 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.


 

$86,300 - $118,700 per year


 

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


About us
 

About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of Humana’s Primary Care Organization, which includes CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer 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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