Role Description - Answering inbound calls from patients, caregivers, and healthcare providers. - Scheduling, confirming, rescheduling, and cancelling appointments. - Registering new patients and collecting demographic and insurance information. - Responding to general questions about services, locations, providers, and availability. - Verifying insurance eligibility and obtaining any required information before appointments. - Routing urgent calls or clinical questions to the appropriate department or therapist. - Following up with patients regarding appointments, referrals, or missing documentation. - Maintaining accurate patient records in the practice management or EMR system. - Providing excellent customer service while handling a high volume of calls. - Ensuring patient information remains confidential and compliant with healthcare privacy regulations. Qualifications - Excellent verbal and written communication skills. - Proven experience in a call center environment. - Familiarity with CRM and EMR systems. - Strong attention to detail and organizational abilities. - Ability to work independently, and available for shifts. - Reliable and adaptable to a dynamic work environment. - Comfortable working U.S. hours. Requirements - Remote work from home. Fraud Disclaimer ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.

Title: Nurse Medical Coder Location: Remote, Nationwide Job Description: Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities - Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models - Validate diagnosis coding and ensure documentation meets compliance standards - Identify and escalate coding trends and documentation gaps - Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach - Partner with clinical and operational teams to drive coding accuracy - Engage and partner with physicians, physician groups, and market leadership to improve documentation and coding practices - Deliver targeted coder education focused on compliance, coding specificity and accuracy - Analyze coding trends, audit findings, and performance metrics to identify opportunities for improvement - Develop actionable insights and recommendations to improve coding accuracy - Support continuous quality improvement processes across CST and stakeholders - Exercise judgment in selecting methodologies and approaches to meet program objectives Use your skills to make an impact Required Qualifications - Active RN license (BSN preferred) or equivalent clinical licensure - Certified Professional Coder (CPC), CRC, CCS - Strong knowledge of ICD-10-CM coding guidelines, risk adjustment methodologies, and documentation standards - Experience with medical record review, coding validation, and audit processes - Proficiency in analyzing and interpreting data trends and applying continuous quality improvement processes - Excellent written and verbal communication skills - Strong proficiency in Microsoft Office tools (Word, Excel, Access) - Demonstrated ability to work independently and manage multiple priorities Preferred Qualifications - Experience in Medicare Advantage risk adjustment (CMS-HCC models) - Background in provider education, clinical documentation improvement (CDI), or market-based consulting - Experience working in a matrixed environment supporting cross-functional teams 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. $86,300 - $118,700 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 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.

• Reviewing and accurately coding all professional services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. • Adhere to MedKoder’s internal coding policies and expectations set forth by department management. • Prioritize daily duties, multitask, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. • Review and accurately code Cardiology IR/CV Surgery and E/M cases to maximize reimbursement in a timely manner. • Review and accurately code E/M visits and office procedures. • Able to work independently and research coding scenarios. • Responsible for meeting daily production and quality goals of consistently averaging a 95% accuracy rate. • Attend conference calls as necessary to provide information and feedback. • Communicate with leadership on coding or documentation issues/trends. • Stay current on all coding guidelines (including specialty-specific guidelines) and maintain credentials as necessary. • Participate in coding department and education meetings.   • Flexible to expand coding skill set into other specialties.  • Maintain confidentiality and protect sensitive information.  • Other duties as assigned by leadership.

Role Description Under direct supervision, accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. Principal Responsibilities and Tasks - Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. - Analyzes, codes and abstracts complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment. - Utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. - Collaborates with other senior coders (and the other coding staff) with sharing coding information and providing coding advice to colleagues regarding complex cases to be coded. - Monitors assigned work on a daily basis in order to facilitate the billing process within the established timeframes. - Codes and abstracts records within timeframes established for each patient type. - Maintains coding quality accuracy rate of 90%. - Maintains productivity rate of 95%. - Communicates with various departments within the hospitals regarding billing and registration issues. Refers any problems to management timely, providing clear details. - Composes appropriate coding queries, works collaboratively with CDI, understands Potentially Preventable Complications (PPC’s)/Maryland Hospital Acquired Conditions (MHAC’s), and Prevention Quality Indicators (PQI’s) and their impact. - Communicates with the Auditing team to discuss audit findings and works collaboratively to ensure that all accounts are coded appropriately and meet standards of compliance. - Complies with AHIMA standards of ethical coding and coding compliance guidelines. - Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager. Qualifications - High School graduate or equivalent. Formal ICD-10-CM and CPT training Associates or Bachelor’s degree preferred. - Minimum of three years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma and Rehab hospital or 4 years of experience with coding inpatient hospital medical records required. - One of the following required: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC). Knowledge, Skills and Abilities - Strong analytical and organizational skills. - Filing systems. - Ability to prioritize workloads and meet deadlines. - Work effectively under pressure. - Excellent customer service skills. - General office procedures. - Ability to problem solve and work with minimal supervision. - Familiar with basic medical terminology. - Computer experience. - Typing ability.