Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Conviva, a wholly owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we’re seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry.

The Medical Coder extracts clinical information from a variety of medical records and assigns appropriate risk adjustment codes (ICD-10-CM) to patient records. The Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.

Responsibilities

Responsibilities

• Identify, assess, monitor, and document coding information as it pertains to Hierarchical Condition Categories (HCC).

• 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.

• Interact with physicians, staff, and mid-levels to ensure accurate coding.

• Complete appropriate paperwork/documentation/system entry regarding encounter information.

• Monitor coding changes to ensure that most current information is available.

• Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.

• Support and participate in process and quality improvement initiatives.

• Other duties as assigned.

Required Qualifications

• Certified medical coder with one of the following certifications CPC, CPC-H or CPMA from AAPC or CCSP, CCS from AHIMA. No CPC-A please.

• ICD 10 knowledge

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

• Excellent verbal and written communication skills

• Proficient in Microsoft Office: Word, Excel, and Outlook

Preferred Qualifications

• Bilingual English/Spanish

• A minimum of 1 year of Medical Risk Adjustment experience, including HCC

Additional Information

Remote- Must live in or near San Antonio, TX

Monday through Friday, 8:00AM to 4:30PM.

Conviva offers tangible and intangible benefits such as medical, dental and vision benefits, 401k, tuition reimbursement, vacation, paid holidays, work-life balance, growth, a positive and fun culture and much more.

Interview Format:

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire Text to enhance our hiring and decision-making ability. Modern Hire Text allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire text interview. In this interview, you will read to a set of interview questions and you will provide text responses to each question. You should anticipate this interview to take about 15 minutes. Your text interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

Vaccine Policy

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Conviva Care Solutions is more than an equal opportunity employer, Conviva's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Conviva roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful.

Scheduled Weekly Hours

40