Review and analyze medical records to assign accurate codes while ensuring compliance with guidelines. Collaborate with healthcare providers to resolve discrepancies and maintain data integrity for billing and reporting purposes. Conduct audits to...

Responsible for the assignment of appropriate. ICD-10-CM/PCS and /or CPT-4 codes to obtain accurate DRG or APC assignment for proper reimbursement and data collection. - Assigns all pertinent ICD-10-CM diagnosis codes and ICD-10-PCS or CPT-4 codes based on official inpatient and outpatient coding guidelines. - Abstracts diagnosis and procedure codes as well as other required data elements as specified by the department or area of the Medical Center into the required Health System computer program (360 CAC, Epic, etc.). - Attends educational sessions. - In addition to the above job responsibilities, other duties may be assigned. - Assigns all pertinent ICD-10-CM diagnosis codes and ICD-10-PCS or CPT-4 codes based on official inpatient and outpatient coding guidelines. - Abstracts diagnosis and procedure codes as well as other required data elements as specified by the department or area of the Medical Center into the required Health System computer program (360 CAC, Epic, etc.). - Attends educational sessions. - In addition to the above job responsibilities, other duties may be assigned.The ideal candidate for a senior inpatient hospital coder has: - Recent coding experience at a major academic medical center. - Knowledge of hospital inpatient coding principles including Diagnosis Related Group (DRG) assignment logic, conditions affecting hospital quality measures such as Hospital Acquired Conditions, Patient Safety Indicators, Present on Admission, and HCCs. - A high level of accuracy, attentiveness to detail, and time management skills for translating complex medical documentation into diagnostic classification system codes. - In-depth knowledge of medical terminology, anatomy and physiology, complex disease processes, pathophysiology, and pharmacology. - Ability to work independently in a teleworking environment, to organize/prioritize work, exercise excellent communication skills, demonstrate follow through skills, and maintain a positive attitude. - AHIMA certification as an RHIA or RHIT with a CCS. MINIMUM REQUIREMENTS Education: High School Graduate or Equivalent. Experience: 5 years of relevant experience. Licensure: Coding certification is required through the AHIMA or AAPC as a RHIA, RHIT, CCS, CCS-P, CPC, CCA, or CPC-H. PHYSICAL DEMANDS This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs PHYSICAL DEMANDS This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally requires traveling some distance to attend meetings, and programs. The starting base rate for this role is $24.24 hourly. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education. Benefits - Comprehensive Benefits Package: Medical, Dental, and Vision Insurance - Paid Time Off, Long-term and Short-term Disability, Retirement Savings - Health Saving Plans, and Flexible Spending Accounts - Certification and education support - Generous Paid Time Off UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond. The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment.

Become a part of our caring community The Senior Workforce Management Professional applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, talent management, inventory management, and human resource compliance). The Senior Workforce Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Workforce Management Professional is an integral member of Humana’s Workforce Management team, supporting the Resolutions segment. This role blends advanced strategic analysis with operational workforce management, focusing on both enterprise-level planning and day-to-day execution to ensure optimal staff deployment and service delivery. Key Responsibilities: - Build and maintain short-range and intermediate forecasting for staffing needs in Resolutions, incorporating near real-time data, utilization trends, and anticipated demand fluctuations. - Set forecasting best practices and influence/oversee scheduling, timekeeping, attendance line, inventory management, and absence management functions, ensuring accuracy and compliance with established policies. - Assess organizational staffing, identify requirements, and recommend solutions to meet both immediate and future workforce objectives. - Provide actionable analysis of talent and staffing needs, supporting strategic and operational goals at the department and segment level. - Demonstrate comprehensive understanding of organizational strategy, departmental objectives, and their linkages to related business areas to inform workforce decisions. - Communicate to and collaborate with leadership and cross-functional teams (Finance, Strategy, Reporting, Process Improvement, etc.) to support operational execution and strategic initiatives, leveraging strong communication, a high degree of Emotional Intelligence and interpersonal skills. - Make independent decisions regarding work methods and approaches, including resolving issues in ambiguous or evolving circumstances with minimal supervision. - Ensure all workforce management activities comply with U.S. federal and Puerto Rico employment laws and Humana’s internal guidelines. - Monitor and report on key workforce metrics; adjust planning and processes as needed to optimize performance and employee engagement. Use your skills to make an impact Required Qualifications - Bachelor's degree or at least 4 years of Workforce Management experience - Comprehensive knowledge of Microsoft Products (Excel, PowerPoint, SharePoint, OneDrive and PowerBI) - Demonstrated ability to articulate ideas effectively in both written and oral forms - Strong analysis, critical thinking, and analytical problem-solving skills - Ability to handle multiple tasks and deadlines with attention to detail - Knowledge and experience in WFM software such as Verint, Aspect, or NICE - Proven experience in workforce management, with expertise in short-range forecasting, scheduling, and operational support - Demonstrated ability to work collaboratively with leadership and teams in a back-office environment - Proven ability to create and maintain strong, collaborative relationships with business partners Preferred Qualifications - Prior experience in Resolutions or back-office team - Finance or strong finance background - Experience in people management - Able to handle rapid business growth or contraction Additional Information This is a remote position. To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. - Satellite, cellular and microwave connection can be used only if approved by leadership. - Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 04-07-2026 About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Department: 10395 Enterprise Revenue Cycle - Individualized Clinician Support Surg Hosp Based and Complex Specialties Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Will support: - Hospital-Based Specialties Desired experience: - Hospitalist, Intensivist, Internal Medicine, Palliative care, Critical Care Schedule: - Monday - Friday 1st shift 40 hours a week - 6am - 6pm EST Certification desired: - Registered Health Information Administrator (RHIA) or - Registered Health Information Technician (RHIT) certification, or - Coding Specialist (CCS) certification, or - Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA) or - Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC). - Additional specialty credential preferred. Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range $35.50 - $53.25 Major Responsibilities: - Deliver proactive coding education through newsletters, scorecards, and presentations, covering CPT (E&M, modifiers), ICD-10-CM, HCPCS, Risk Adjustment, payer requirements, and rejection resolutions. - Lead onboarding and compliance training for all employed Physicians/APPs, including Locum Tenens, residents, and students, ensuring documentation accuracy from the start. - Provide individualized documentation feedback by reviewing new clinician records and conducting spot checks, escalating non-coding issues to appropriate teams. - Serve as the primary contact for coding inquiries, coordinating with internal teams to resolve complex issues such as NCCI bundling and high-complexity charge edits. - Monitor Epic work queues (charge review, follow-up, claim edit) to ensure timely and accurate charge submissions and reduce claim denials. - Collaborate across departments—including CMOs, Clinical Informatics, Risk Adjustment, and Population Health—to enhance documentation practices and system optimization. - Participate in specialty and department meetings, identifying trends and delivering targeted education to improve coding and documentation accuracy. - Refine Epic documentation tools, including templates, order entries, diagnosis lists, and SmartSets/SmartPhrases, to improve efficiency and accuracy. - Ensure compliance with regulatory standards, including Medicare, Medicaid, and AHIMA’s Standards of Ethical Coding, while maintaining expert knowledge of evolving policies. - Promote a culture of ethical coding and continuous improvement, supporting clinicians with timely updates, feedback, and education to ensure accurate reimbursement and compliance. Licensure, Registration, and/or Certification Required: - Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification, or Coding Specialist (CCS) certification, or Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA) or Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC). Additional specialty credential preferred. Education Required: - Completion of advanced training through a recognized or accredited program, equivalent in scope and rigor to post-secondary education or equivalent knowledge. High school diploma or GED required. Experience Required: - Typically requires 4 years of experience in expert-level professional coding. Knowledge, Skills & Abilities Required: - Advanced Coding Expertise: In-depth knowledge of ICD, CPT, and HCPCS coding guidelines, ensuring accurate and compliant coding practices. - Medical Terminology & Anatomy: Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment. - Epic & Reporting Solutions: Advanced knowledge of Epic and other reporting tools to analyze data, generate reports, and optimize workflow efficiencies. - Critical Thinking & Analytical Skills: Highly proficient in problem-solving and analytical thinking with strong attention to detail. - Interpersonal Communication: Excellent verbal and written communication skills, with the ability to educate and collaborate effectively with physicians, APCs, clinical leadership, and coding teams. - Advanced Computer Skills: Proficiency in Microsoft Office Suite, electronic coding applications, and email communication. - Organizational & Prioritization Skills: Ability to efficiently manage multiple tasks, set priorities, and meet deadlines in a fast-paced environment. - Independent Decision-Making: Ability to work independently, exercise sound judgment, and make informed decisions regarding coding and compliance. - Collaboration & Initiative: Strong ability to take initiative, contribute to process improvements, and work collaboratively within a team environment. Physical Requirements and Working Conditions: - Follow organizational and divisional remote work policy and guidelines. - Operates all equipment necessary to perform the job. - Handles a fast paced and creative work environment moving independently from one task to another. - Makes sound decisions within limited time frames and always conducts business in a professional manner and has demonstrates ability to work cooperatively and effectively with others on an individual and team basis. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. #REMOTE #LI-REMOTE Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation - Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training - Premium pay such as shift, on call, and more based on a teammate's job - Incentive pay for select positions - Opportunity for annual increases based on performance Benefits and more - Paid Time Off programs - Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability - Flexible Spending Accounts for eligible health care and dependent care expenses - Family benefits such as adoption assistance and paid parental leave - Defined contribution retirement plans with employer match and other financial wellness programs - Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.