Risk Adjustment Representative 3

Employment Type: Full-time

Position Overview

Become a part of our caring community and help us put health first. The Risk Adjustment Representative 3 is a remote access role working with providers, vendors, projects, and record retrieval associates. This position is production-driven, fast-paced, and requires remarkable communication skills. You will manage multiple tasks throughout the day, prioritize while staying organized, and maintain professional composure at all times.

Responsibilities

• Conduct risk adjustment audits.
• Monitor and maintain provider locations.
• Work with copy services.
• Complete medical record retrievals.
• Assist retrieval associates.
• Interact with provider staff, including front desk associates, office managers, nurses, medical record associates, and doctors.
• Manage phone calls professionally, even when challenging.
• Perform administrative tasks for retrieval management as needed.
• Utilize your skills to make an impact.

Requirements

• Located in GA or SC.
• 2 or more years of Healthcare customer service / Release of Information experience (within the past 5 years).
• 2 or more years of Medical Record and/or health information experience.
• 2 or more years of demonstrated ability in using computer and Windows PC applications, including strong keyboard and navigation skills and the ability to learn new computer programs.
• Proficient in Microsoft Word and Excel.
• Proficient in Microsoft Outlook, including calendar management.

Preferred Qualifications

• Medical Record Retrieval knowledge.
• RADV experience (Risk Adjustment Data Validation).
• Strong written and verbal communication skills.
• Strong analytical, organizational, and time management skills.
• Administrative, medical administration, or provider office experience.
• Knowledge and experience in a healthcare environment/managed care.
• Working knowledge of computers or demonstrated technical aptitude and ability to quickly learn new systems.

Travel

• Travel up to 25% of the time.
• This may include driving to locations close to home or driving to locations requiring overnight travel for up to a week at a time.

Additional Information

• Department Hours: Monday - Friday, 7 am to 5 pm EST.

Interview Process

As part of our hiring process, we will be using interviewing technology provided by HireVue. If selected to move forward, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.

• Pre-recorded Voice Interview: Respond to questions via your phone. Expect this to take approximately 10-15 minutes.
• SMS Text Interview: Answer questions using your cell phone or computer. Expect this to last anywhere from 5-10 minutes.

Your recorded interview(s) will be reviewed, and you will be informed if you will be moving forward to the next round of interviews.

Work at Home Guidance

To ensure effectiveness for Home or Hybrid Home/Office associates, your self-provided internet service must meet the following criteria:

• Recommended: A download speed of at least 25 Mbps and an upload speed of 10 Mbps.
• Connection Types: Wireless, wired cable, or DSL connection is suggested.
• Satellite, Cellular, and Microwave: Can be used only if approved by leadership.
• Internet Expense Reimbursement: Associates living and working from home in California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Equipment: Humana will provide telephone equipment appropriate to meet the business requirements for your position.