Humana Inc. logo

Risk Adjustment Representative

Job Overview

Location

Work at Home - North Carolina

Job Type

Full-time

Category

HR & Recruiting

Date Posted

July 10, 2026

Full Job Description

đź“‹ Description

  • • Conduct 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.
  • • Perform varied activities and moderately complex administrative/operational/customer support assignments, performs computations and works on semi-routine assignments.
  • • Ensure coding is accurate and properly supported by clinical documentation within the health record.
  • • Follow state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records.
  • • Participate in provider education programs on coding compliance.
  • • This position will be based from a home office with occasional travel to the office in Charlotte, NC for training and as needed for team meetings.
  • • Occasional travel to retrieve records from provider locations throughout the counties of Bertie, Camden, Chowan, Currituck, Dare, Gates, Halifax, Hertford, Martin, Pasquotank, Perquimans, Tyrrell, Washington.
  • • Use your skills to make an impact.

🎯 Requirements

  • • Minimum 6 months of medical record retrieval experience.
  • • Experience in customer service within a healthcare setting.
  • • Proficiency in all Microsoft Office applications, including Word and Excel.
  • • Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
  • • Must be agreeable to occasional travel to the Humana office in Charlotte, NC and to provider locations throughout the region to support business needs.

🏖️ Benefits

  • • Competitive benefits that support whole-person well-being.
  • • Medical, dental and vision benefits.
  • • 401(k) retirement savings plan.
  • • Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
  • • Short-term and long-term disability.
  • • Life insurance.

Skills & Technologies

Remote
$40k-52k
Degree Required

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Humana Inc.
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About Humana Inc.

Humana Inc. is a for-profit health and well-being company headquartered in Louisville, Kentucky. Founded in 1961, it provides health insurance, Medicare Advantage plans, Medicaid services, pharmacy benefit management, and clinical care through primary care centers. Serving millions of members across the United States, Humana focuses on integrated care delivery, home health, and wellness programs aimed at improving health outcomes and reducing costs for individuals, employers, and government partners.

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