Medical Coder / Educator / Local travel
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Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.
Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.
Role: Clinical Innovations Analyst
Assignment: Coder Analyst
Location: Doral, Florida
Are you a fit?
Do you enjoy working with clinical data? Do you have a desire to be in a position where you can use your analysis to recommend support new strategies? If so then read on!
Assignment Capsule
The role of the Clinical Innovations Analyst is to identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories.
- Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered.
- Review medical record information to identify all appropriate coding based on CMS HCC categories.
- Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
- Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.
- Support and participate in process and quality improvement initiatives.
- Review office documentation and process - identify areas where there is breakdown. Offer recomendations for improvement. Be a resource to be used for Coder Education to personnel in the office.
- Act as a support system, review, educator, and guidance to the provider offices. Finding additional resources for billing.
Key Competencies
- Builds Trust: You honor your word by doing what you say you are going to do.
- Drives for excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition.
- Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.
- Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
Role Essentials
- Certified Medical Coder ( CPC, CPC-P) or (CCS, CCS-P) with high degree of competence in this area and strong background in the role with experience in office provider education and staff.
- Needs to be a member of the AAPC or AHIMA - Must
- Must be fully bilingual - English/Spanish
- Prior coding experience, preferably in a medical office environment
- Strong knowledge of Microsoft Office XP products (Word, Excel, Access, Power Point and Presenting Skills and Education skills)
- 3 to 5 years of experience working in a Healthcare environment in the Medical Coder- preferrably field and office visits.
- Associates Degree in Business, Healthcare or Related Environment or commensurate with work experience
- Extensive travel outside of the office is required and a valid drivers license is required.
- Must have reliable transportation. Primarily travel within Miami Dade County. Possibly support other areas within Florida - like Broward, Palm Beach, East Coast, West Coast or central Florida on ocassion.
- Professional demeanor and appearance, strong work ethic, reliable, resourceful, enthusiastic, team player with positive attitude
- Strong written and verbal communication skills; strong analytical, organizational and time management skills required
Role Desirables
- Bachelor's Degree
- Knowledge and experience in health care environment/managed care
Reporting Relationships
You will report to a Clinical Supervisor or Manager. This area is under the leadership of the SVP & Chief Operations Officer.
Additional Information
Normal business hours, but ocassional opportunity for evening meetings. No weekend hours.
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