Clinical Innovations Certified Coder – Tampa

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: Certified Coder
Assignment: Clinical Innovations
Location: Tampa, FL

Are you a fit?
Are you a certified medical coder? Do you enjoy conducting medical chart reviews, going out to provider's offices, coding medical charts, and working with providers and office staff? Do you have a desire to be in a position where you can use your analysis to recommend and 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. We are seeking to identify coding issues and deal with them in a timely manner while educating providers and their staff on how to prevent future issues.

• 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.
  
• Assure the accuracy, completeness, specificity and appropriateness of diagnosis 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.

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 or CCS) with high degree of competence in this area. You must be proficient with ICD-9 coding.
  
• Prior coding experience, preferably in a medical office or inpatient environment.
  
• Strong knowledge of Microsoft Office XP products (Word, Excel, Access).
  
• Travel outside of the office will be required. A valid driver's license and reliable transportation is a must.
  
• Professional demeanor and appearance, strong work ethic, reliable, resourceful, enthusiastic team player with a positive attitude. You will be dealing with health care providers and will be the face of Humana.
  
• Strong written and verbal communication skills; strong analytical, organizational and time management skills required.

Role Desirables

• Knowledge and experience in health care environment/managed care.
  
• A clinical background is a plus. Registered nurses who are certified coders are strongly encouraged to apply.

Reporting Relationships
You will report to a Clinical Supervisor or Manager. This area is under the leadership of the SVP & Chief Operations Officer.

Apply Here