Humana

Coding Educator

South Carolina, United States

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

Requirements

Candidates must possess an AHIMA or AAPC CPC certification and have 3 or more years of experience in medical coding education and/or auditing within a healthcare setting. Proficiency with data analytics tools such as Excel or Power BI, experience interpreting large datasets, and strong presentation skills including public speaking and webinars with healthcare providers are required. Knowledge of Risk Adjustment and coding guidelines is necessary, and candidates should ideally live in South Carolina or Georgia. A Bachelor's degree, CRC certification, experience interacting with healthcare providers, strong Microsoft Office skills, attention to detail, and a valid driver's license are preferred.

Responsibilities

The Coding Educator 2 will identify opportunities to improve provider documentation and create tailored education plans for assigned providers. Responsibilities include arranging educational sessions focused on quality of care and documentation improvements, identifying educational needs based on reports, and preparing comprehensive reports and presentations on coding quality trends using data visualization. The role involves providing onsite education as needed, collaborating with other market provider-facing roles, and utilizing data analytics tools to assess coding quality, identify error patterns, and monitor compliance. Additionally, the educator will analyze coding audit results to develop data-driven educational materials and participate in cross-functional teams to enhance documentation, data integrity, and workflow processes.

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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