Humana Hiring for Risk Adjustment Administration Representative 4 – WAH NC at Charlotte, North Carolina Full Time

Description

The Risk Adjustment Administration Representative 4 responsible for obtaining accurate healthcare information from providers to ensure appropriate clinical care for members and maintain accurate payment levels. The Risk Adjustment Administration Representative 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.

Responsibilities

The Risk Adjustment Administration Representative 4 may conduct analysis of data, provider or member outreach, and/or record retrieval. For Risk Adjustment Coding, please use that job family. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards retrieval scheduling, weekly/ yearly goals, and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. Works within broad guidelines with little oversight.

Required Qualifications

• 3+ years of experience working as a medical records retrieval specialist, in a provider office or healthcare administration, or copy service company

• Proficiency in all Microsoft Office applications, including Word and Excel

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

• Valid Drivers License and reliable transportation

• We will require full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve.

• If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law. Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work.

Preferred Qualifications

• Bachelor’s Degree

• Strong written and verbal communication skills; strong analytical, organizational and time management skills

• Knowledge and experience in health care environment/managed care

• Strong knowledge of ICD-9/10 codes

Scheduled Weekly Hours

40