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Remote Risk Adjustment Auditor Jobs in Indiana (NOW HIRING)

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Attorney Auditor

Indianapolis, IN · Remote

$70K - $75K/yr

This is a fully remote position, and candidates residing in any of the 50 United States are ... Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive ...

... ON REMOTE WORK OPTION; 5 days per week; 8:00a-4:30p; Mon-Fri) 101 Truman Medical Center Job ... detailed auditing, monitoring, and provider education related to coding, billing, and clinical ...

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Remote Risk Adjustment Auditor information

What are the key skills and qualifications needed to thrive as a Remote Risk Adjustment Auditor, and why are they important?

To thrive as a Remote Risk Adjustment Auditor, you need strong knowledge of medical coding (CPT, ICD-10), healthcare compliance, and experience with risk adjustment methodologies, typically supported by a coding certification such as CPC, CRC, or CCS. Familiarity with electronic health record (EHR) systems, coding audit software, and secure remote work platforms is essential. Attention to detail, analytical thinking, and effective written communication are important soft skills for interpreting complex medical records and collaborating with healthcare providers. These skills ensure accurate risk adjustment coding, regulatory compliance, and optimized reimbursement processes in a remote work environment.

What are some common challenges Remote Risk Adjustment Auditors face, and how can they overcome them?

Remote Risk Adjustment Auditors often encounter challenges such as interpreting complex medical records, staying current with changing coding guidelines, and effectively communicating with team members in a virtual environment. To overcome these, auditors should prioritize ongoing education on coding standards, utilize secure collaboration tools to stay connected with colleagues, and develop strong organizational skills to manage multiple assignments efficiently. Proactively seeking feedback and participating in team meetings can also help maintain accuracy and a sense of community while working remotely.

What is a Remote Risk Adjustment Auditor?

A Remote Risk Adjustment Auditor is a healthcare professional who reviews medical records and documentation from a remote location to ensure accurate coding for risk adjustment purposes. Their work helps health plans and providers comply with government regulations and receive appropriate reimbursement for patient care. They analyze clinical documents to validate diagnoses, identify coding errors, and ensure data integrity. Remote auditors use specialized software and follow strict confidentiality guidelines while working from home or another offsite location.

What is the difference between Remote Risk Adjustment Auditor vs Remote Medical Coder?

AspectRemote Risk Adjustment AuditorRemote Medical Coder
CertificationsCPMA, RAC, or RHITAAPC CPC, CCS, or RHIT
Work EnvironmentInsurance, healthcare auditing firmsHospitals, clinics, insurance companies
Job FocusReviewing documentation for risk adjustment accuracyAssigning medical codes to patient records

Remote Risk Adjustment Auditors and Remote Medical Coders often share certifications and work in healthcare settings. However, auditors focus on reviewing documentation for risk adjustment purposes, while coders assign medical codes directly to patient records. Both roles require healthcare knowledge but serve different functions within the industry.

What are popular job titles related to Remote Risk Adjustment Auditor jobs in Indiana? For Remote Risk Adjustment Auditor jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Remote Risk Adjustment Auditor jobs in Indiana look for? The top searched job categories for Remote Risk Adjustment Auditor jobs in Indiana are:
What cities in Indiana are hiring for Remote Risk Adjustment Auditor jobs? Cities in Indiana with the most Remote Risk Adjustment Auditor job openings:
Clinical Coding Educator

Clinical Coding Educator

Humana

Valparaiso, IN • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago


Humana rating

8.0

Company rating: 8.0 out of 10

Based on 251 frontline employees who took The Breakroom Quiz

144th of 259 rated insurance


Job description

Become a part of our caring community
The Clinical Coding Educator / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment

As the Clinical Coding Educator / Coding Educator 2 you will

  • 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

  • Use 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


Use your skills to make an impact

Required Qualifications

  • 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 speaking with leadership, webinars public speaking and/or presentation skills with healthcare providers

  • Risk Adjustment knowledge

  • Familiar with coding guidelines

  • Live in NC, SC, GA, VA, MD or TN

Preferred Qualifications

  • Bachelor's Degree

  • CRC -Certified Risk Adjustment Coder

  • Experience working with healthcare providers

  • Strong knowledge of all Microsoft Office applications

  • Valid Driver's license and reliable transportation

  • Medicare Risk Adjustment knowledge

Additional Information

Work at home - with travel (up to 5%) to surrounding provider offices

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

  • Satellite, cellular and microwave connection can be used only if approved by leadership

  • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

#LI-BB1

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$59,300 - $80,900 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.


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About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

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