Role: MRA Learning Facilitator *Assignment: *Medicare Risk Adjustment
*Location: *Daytona, FL
We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our consumers, providers, employers, agents and others we work with. At Humana, Perfect Service® means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our members, employers, providers, and colleagues. We’re looking for people who improve their own well-being by looking out for the best interests of others.
Assignment Capsule Be a part of our Learning organization - deliver value and quality in a fast paced environment.
Humana is seeking a Learning Facilitator who will be responsible for the following: * Review and analyze medical records no more than 25% of the time using various modeling tools for Risk Adjustment to identify educational opportunities. * Educate physician, office staff and MSO’s on specific, consistent and accurate medical record documentation based on Regulatory Agency (i.e. CMS, AHCA) and ICD-10-CM coding guidelines. * Act as a liaison between Humana and contracted providers/MSO’s to facilitate and maintain a “team” approach. * Utilize negotiation skills in order to build/maintain strong, trusting, productive relationships with both internal and external partners. * Assess provider educational needs in order to develop a curriculum and deliver learning interventions and/or workshops for both internal and external partners. * Utilize specialized project management methods to define the scope, logistics and documentation practices needed for various special projects. * Conduct evaluations to ensure the effectiveness of implemented educational programs; and make and/or recommend modifications as necessary. * Apply Adult Learning Principles utilizing various methods and media to deliver technical content. * Deliver educational content professionally by stating a clear course purpose. * Demonstrate an effective, face-to-face communication style, promptly addressing and resolving issues as they arise. * Support the team’s success by providing the necessary resources and breaking down barriers/obstacles.
Role Essentials * High school diploma or equivalent * Certified Coder with either CPC, CCS or CCS-P * Minimum of 2 years coding experience * Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Strong attention to detail * Exceptional interpersonal, public speaking and presentation skills * Intermediate knowledge of Microsoft Office applications, including Word, Excel and PowerPoint * Valid driver's license with ability to travel up to 75% of time in the state of Florida with possible overnight stays
Role Desirables * Associates and/or Bachelor’s Degree in Health related Field * Familiar with Regulatory Agency guidelines (i.e. CMS, AHCA) and/or MRA coding experience
At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.
Title: MRA Learning Facilitator
Location: FL-Daytona Beach
Requisition ID: 189619
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.