Certified Medical Coder - Knoxville, TN
Humana - Knoxville, TN

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The role of the Clinical Innovations Analyst is to identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories.

Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered.

Review medical record information to identify all appropriate coding based on CMS HCC categories.

Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.

Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.

Support and participate in process and quality improvement initiatives.

Key Competencies

Builds Trust: You honor your word by doing what you say you are going to do.

Drives for excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition.

Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.

Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.


Role Essentials

Certified Medical Coder with high degree of competence in this area

Prior coding experience, preferably in a medical office environment

Strong knowledge of Microsoft Office XP products (Word, Excel, Access)

High school diploma or equivalent required

Extensive travel outside of the office is required and a valid drivers license is required,

Must have reliable transportation.

Role Desirables

Bachelor’s Degree

Knowledge and experience in health care environment/managed care

Professional demeanor and appearance, strong work ethic, reliable, resourceful, enthusiastic, team player with positive attitude

Strong written and verbal communication skills; strong analytical, organizational and time management skills required

Reporting Relationships

You will report to a Clinical Supervisor or Manager. This area is under the leadership of the SVP & Chief Operations Officer.




Primary Location





Clinical Innovations and Health Practitioners

Work Environment Type





Yes, 10 % of the Time

About this company
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Humana Inc. (Humana) is a full-service benefits solutions company, offering an array of health and supplemental benefit plans for employer...