# Risk Adjustment Representative 3

**Company**: Humana Inc.
**Location**: Remote California
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $43,000 - $56,200 per year
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-California/Risk-Adjustment-Representative-3_R-431422?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_05abd382-e41

## Description

The Risk Adjustment Representative 3 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies.

This role performs advanced administrative/operational/customer support duties that require independent initiative and judgment, and may apply intermediate mathematical skills.

Key responsibilities:

- Manage sites assigned and track records received to a specified goal

- Document progress and calls made daily, and complete daily productivity reports

- Research site information and update information internally

- Collaborate with IPA and Medical Groups

- Adapt to changes and business purposes

- Back up to leadership with processes and procedures

**Required Qualifications**

- High School Diploma

- 3 or more years of experience in a healthcare environment/managed care (provider office, billing, coding, medical records, etc.)

- Proficiency in Microsoft Office applications: Word, Excel, and PowerPoint

- Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits

- Strong written and verbal communication skills

- Organizational and time management skills

- Ability to travel up to 20% to provider offices within CA

- Understanding of IPA

**Preferred Qualifications**

- Medical record terminology

- Knowledge of contracting

**Additional Information**

- Monday - Friday business hours (8-5pm Pacific Time Zone)

- Overtime as needed

- Hours subject to change based on business needs

**Work at Home Requirements**

- Minimum download speed of 25 Mbps and upload speed of 10 Mbps

- Wireless, wired cable or DSL connection

- Dedicated workspace with minimal interruptions

**Scheduled Weekly Hours**

- 40

**Pay Range**

- $43,000 - $56,200 per year

## Skills

### Required
- Microsoft Office
- communication skills
- time management
- IPA

### Nice to have
- medical record terminology
- contracting knowledge

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Source: [Apply at humana.wd5.myworkdayjobs.com](https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-California/Risk-Adjustment-Representative-3_R-431422?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)