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Risk Adjustment Coding Professional 1 (CPC) - Remote/Work at Home United States



The Risk Adjustment Coding Professional 1 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coding Professional 1 work assignments are often straightforward and of moderate complexity.


The Risk Adjustment Coding Professional 1 ensures coding and auditing is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines while analyzing coding and auditing information and medical records. May participate in provider education programs on coding and auditing compliance. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

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Required Qualifications
  • 3 years of coding experience
  • CPC (Certified Professional Coder) Certification required
  • Proficiency in all Microsoft Office Programs including Word, PowerPoint, Excel, Access, etc.
  • Prior coding experience in a medical office environment
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications
  • Bachelor's degree
  • Strong analytical, organizational and time management skills
  • Strong knowledge of ICD-10 coding/managed care

Additional Requirements
  • Hours: Must be willing to work an 8 hour shift between 6:00 AM and 5:00 PM Eastern Time.
  • Travel: May be authorized travel to attend Coding conference and or a team buildingevent, but not more than 5%.

Additional Information

As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, 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 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.

Scheduled Weekly Hours


Job ID: humana-R-271010
Employment Type: Other