Role Description The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement. - Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding. - Advanced Documentation Improvement & Education: Analyze clinical documentation across the network to identify patterns, trends, and opportunities for improvement related to HCC capture. Develop and deliver effective education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category coding capture. Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles. - Compliance & Regulatory Insight: Continuously monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within the risk adjustment landscape, applying this knowledge to daily coding and education efforts. Champion a culture of compliance by advocating for best practices and providing robust provider support to ensure CommonSpirit adheres to all federal and coding guidelines pertaining to HCC and risk adjustment. Safeguard medical records and preserve the confidentiality of personal health information through adherence to all relevant policies (release of medical record information, record retention, HIPAA privacy and security). - Process Improvement & Collaboration: Actively participate in network performance improvement initiatives, offering insights and solutions based on coding expertise. Collaborate with providers and office staff to address documentation deficiencies and coding gaps. Qualifications - 2+ years of experience in outpatient coding - 2+ years focused on risk adjustment and HCC principles - Advanced knowledge of CPT and ICD-10 coding, with significant expertise in HCC coding guidelines and risk adjustment models - Strong understanding of federal and state guidelines on all coding systems and sponsored programs - Proficiency in developing and delivering educational content - Effective interpersonal, communication, and presentation skills (both verbal and written) - Ability to manage multiple priorities and work independently - Computer literacy in medical information systems, records management software, and encoder software Requirements - 4+ years of experience in outpatient coding (preferred) - 3+ years focused on risk adjustment and HCC principles (preferred)

Title: Consultative Coding Professional - Hybrid Location: Remote Louisiana Remote Texas Remote Mississippi Job Description: The Consultative Coder provides medical coding expertise to support clinical staff (Physicians and Advanced Practice Providers) to ensure the documentation within medical records supports diagnostic and procedural coding. Location: This is a Hybrid role candidate(s) must reside in Louisiana/Mississippi/Texas. You will report to the Manager, Medical Coding. Relationship/Concierge Services: - Cultivate relationships with clinicians (Physicians and Advanced Practice Providers) to serve as the single contact for questions and issues relating to documentation and coding. - Based on one-on-one engagement with clinicians, identify documentation improvement areas and partner with clinical and coding education to deliver education related to improvement opportunities - Analyze trends, assessment, and answer questions in real-time. - Research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. Post-Visit/Offshore Coding Collaboration: - Perform Quality Assurance on post-visit reviews. You will determine frequency and sampling methodology) - Review the encounter for potential missed opportunities. - Address nonbillable services at the provider level. - Address documentation deficiencies resulting in not billable services promptly (missing chief complaint, missing time for audio only visits, and missing telehealth platform) - Work with provide updates on documentation requirements and process changes. Mergers and Acquisitions: - Responsible for the special handling of Mergers & Acquisitions: - Perform Problem list cleanup (as outlined by compliance) - Conduct PCO Process training including reporting for open notes and addendums, and gap attestation process and performance expectations. - Train acquired providers on PCO documentation requirements and processes. Other Responsibilities: - Lead Special Projects within the Division/Markets - As requested by Market leaders, perform the following tasks: - Analyze AWV completion rates (what criteria is needed to complete AWV) - Analyze EDAPS; report the variances between datahub and eCW. - Conduct Chart reviews to identify educational opportunities. - Perform individual chart research. - Collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies. - Participate in Payer calls/chart reviews. - Compile payer findings and assist with research. Participate in payor meetings/discussions to ensure accurate data submission. Required Qualifications: - Three years Medical Coding experience or similar (including IPA and Offshore coding management) - RHIA, RHIT, CCS, or CPC Certification - Ability to travel both locally and overnight based on business need - Must reside in LA/MS/TX Use your skills to make an impact Work at Home Statement To ensure Home or Hybrid Home/Office employees', the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: - We require at minimum a download speed of 25 Mbps and an upload speed of 10 Mbps; we suggest a wireless, wired cable or DSL connection. - Satellite, cellular and microwave connection leadership approves only if used. - We will provide employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Interview Format – HireVue As part of our hiring process for this opportunity, we will use an interviewing technology called HireVue to enhance our hiring. HireVue allows us to quickly connect and gain valuable information from you about your relevant experience at a time that is best for your schedule.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. $59,300 - $80,900 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. About us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being. About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). 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.

• Coding of Gastroenterology procedures, surgeries, hospital and office visits • Verify and ensure the accuracy and completeness of diagnosis codes based on services rendered • Complete appropriate documentation or system entry regarding claims • Abstract additional data elements during the Chart Review process when coding • Identify appropriate assignment of CPT and ICD-9 Codes for Physician and facility services • Remains current on medical coding and billing guidelines and auditing protocols

Role Description This Medical Records Technician Coder (In/Out) position is in support of the Health Information Management Section (HIMS) of the White River Junction VA Medical Center. - Medical Record Technicians (MRT) Coders are responsible for classifying medical data from patient health records in various settings. - MRTs analyze and abstract patients' health records and assign alpha-numeric codes for each diagnosis and procedure. Major duties include but are not limited to: - Assigns codes to inpatient admissions; develops skill and knowledge of health record coding. - Adheres to accepted coding practices, guidelines, and conventions to ensure ethical, accurate, and complete coding. - Assists facility staff with documentation requirements to accurately reflect patient care provided. - Codes inpatient admissions to obtain the most appropriate MS-DRG, including all MCCs, CCs, and correct POAs. - Selects and assigns codes from the current versions of the International Classification of Diseases (ICD) and the Procedural Coding System (PCS). - Reviews health record documentation to abstract all required medical, surgical, demographic, social, and administrative data. - Utilizes the facility computer system and software applications to code, abstract, record, and transmit data to the national VA database. - Operates various window-based applications such as Outlook, Excel, Word, and Access. - Refers coding and documentation questions from providers to a senior coder or supervisor for resolution or guidance. Work Schedule: Full time, Days Virtual/Remote Work Status: This position is eligible for Remote/Virtual work, but may require in-person attendance as per management's discretion. Functional Statement #: 402-F03429, F03469, F03468, F03467, F03478 Notifications: Current and former Federal employees must submit copies of their most recent SF-50, which must identify the position title, series, grade, step, tenure, and type of service. Qualifications - Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected. - Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Basic Requirements: - United States Citizenship - English Language Proficiency. - MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. 7403(f). - Experience: One year of creditable experience indicating knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and health records. - Education: - An associate's degree from an accredited college or university in health information technology/management or related field. - Completion of an AHIMA approved coding program or other intense coding training program. - Equivalent combinations of creditable experience and education are qualifying. - Certification: - Apprentice/Associate Level Certification through AHIMA or AAPC - Mastery Level Certification through AHIMA or AAPC - Clinical Documentation Improvement Certification through AHIMA or ACDIS Requirements - Grade Determinations: - MRT (Coder-In/Out), GS-04: None beyond basic requirements. - MRT (Coder-In/Out), GS-05: One year of creditable experience equivalent to the next lower grade level or a bachelor's degree. - MRT (Coder-In/Out), GS-06: One year of creditable experience equivalent to the next lower grade level. - MRT (Coder-In/Out), GS-07: One year of creditable experience equivalent to the next lower grade level. - MRT (Coder-In/Out), GS-08: One year of creditable experience equivalent to the next lower grade level. Benefits - Position is mostly sedentary, in an office type setting. - Some light lifting (under 15 lbs.) and light carrying (under 15 lbs.) required. - Use of fingers to keyboard and ability to read electronic health records on computer screen.