Humana

Coding Educator

South Carolina, United States

Not SpecifiedCompensation
Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

About the Role

Employment Type: Full time

Become a part of our caring community and help us put health first. The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 will be responsible for arranging educational sessions with assigned providers aimed at quality of care and documentation improvements.

Key Responsibilities

  • Identify educational needs based on reports
  • Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques.
  • Provider onsite education, based on business needs
  • Collaboration with other market provider facing roles
  • Utilize data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards.
  • Analyze coding audit results and other relevant data to develop data-driven educational materials and interventions.
  • Participate in cross-functional teams to improve documentation, data integrity, and workflow processes
  • Use your skills to make an impact

Required Qualifications

  • AHIMA or AAPC CPC (Certified Professional Coder) Certification
  • 3 or more years of medical coding education and/or auditing in a healthcare setting experience
  • Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets
  • Experience with speaking with leadership, webinars, public speaking and/or presentation skills with healthcare providers
  • Risk Adjustment knowledge
  • Familiar with coding guidelines
  • Live in South Carolina or Georgia

Preferred Qualifications

  • Bachelor's Degree
  • CRC - Certified Risk Adjustment Coder
  • Experience interacting with healthcare providers
  • Strong technical knowledge of all Microsoft Office applications
  • Strong attention to detail and exceptional follow up skills
  • Valid Driver's license and reliable transportation
  • Medicare Risk Adjustment knowledge

Additional Information

Work at home - with ability to travel (up to 5%) to surrounding provider offices

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.

If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Work from Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
  • Satellite, cellular and microwave connection can be used only if approved by leadership

Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Skills

Medical coding education
Auditing
Data analytics
Excel
Power BI
Data visualization
Public speaking
Presentation skills
Risk Adjustment
Coding guidelines
Microsoft Office
Attention to detail
Follow up skills

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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