HIM Clinical Data Quality Auditor and Educator
Virta HealthSalary not specified
- Full Time
- Junior (1 to 2 years)
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Health InsuranceIndustries
Requirements
Candidates must possess a Certified Coder Certification such as CPC, CCS, or CCA, along with a minimum of 3 years of related coding and Risk Adjustment experience. Proficiency in Microsoft Office programs, including Word, PowerPoint, Excel, Access, and strong collaboration and relationship-building skills are required. Demonstrated ability to manage multiple tasks and meet deadlines is also necessary.
Responsibilities
The Risk Adjustment Coding Professional conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes submitted to CMS and other government agencies, ensuring coding accuracy and proper clinical documentation support. They follow state and federal regulations and internal policies, analyze coding information, and may participate in provider education programs on coding compliance. Additionally, the professional may be required to work overtime and travel occasionally for training or meetings.
Skills
ICD-10 coding
Medical record review
ICD-9/10 diagnosis codes
CMS regulations
Coding compliance
Microsoft Office (Word, PowerPoint, Excel, Access)
Analytical skills
Organizational skills
Time management
Provider education
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.
Key Metrics
Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees