[Remote] Coding Educator at Humana

South Carolina, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

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

Responsibilities

Identify opportunities to improve provider documentation and creates an education plan tailored to each assigned provider
Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements
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 role
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
Work at home - with ability to travel (up to 5%) to surrounding provider offices

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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