Become a part of our caring community
 

The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. You will perform varied activities and moderately complex administrative/operational/customer support assignments, performs computations and works on semi-routine assignments.

The Risk Adjustment Representative 2 ensures coding is accurate and properly supported by clinical documentation within the health record. You will follow state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. You may participate in provider education programs on coding compliance.

This position will be based from a home office with occasional travel to the office in Charlotte, NC for training and as needed for team meetings. There will also be occasional travel to retrieve records from provider locations throughout the counties of Bertie, Camden, Chowan, Currituck, Dare, Gates, Halifax, Hertford, Martin, Pasquotank, Perquimans, Tyrrell, Washington.

Use your skills to make an impact
 

Required Qualifications

• Minimum 6 months of medical record retrieval experience
• Experience in customer service within a healthcare setting
• Proficiency in all Microsoft Office applications, including Word and Excel
• This job is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits and requires running a Motor Vehicle Report as part of the background check process. 
• Must be agreeable to occasional travel to the Humana office in Charlotte, NC and to provider locations throughout the region to support business needs.

Preferred Qualifications

• Bachelor's Degree
• Strong written and verbal communication skills; strong analytical, organizational and time management skills
• Experience working in a managed care environment
• Knowledge of ICD-9/10 codes

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.

 

$40,000 - $52,300 per year

 

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.

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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.