IPA Consultative Coder - Southeast Florida (Daytona)

Become a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide, including MSO-contracted independent providers. You will serve as the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives.

Responsibilities

• Analyze trends, triage, and answer coding and documentation questions in real-time.
• Research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.
• Manage a panel of up to 30 providers within a defined market or region, delivering ongoing education and support for coding workflows.
• Ensure alignment on organizational documentation and coding standards.
• Collaborate with STARS leaders and champions to identify gaps and deficiencies.
• Serve as the primary contact for assigned IPA providers for all coding and documentation-related inquiries.
• Build consultative relationships with providers to support continuous improvement in coding accuracy and documentation practices.
• Deliver targeted education based on provider-specific trends identified through chart reviews and coding analytics.
• Conduct quarterly chart reviews to evaluate coding accuracy, documentation integrity, and risk capture opportunities.
• Develop and deliver comprehensive education based on findings, including documentation best practices and coding optimization strategies.
• Identify trends and recurring gaps, partnering with education and leadership teams to address systemic opportunities.
• Support daily operations of internal coding solutions, including Annual Proof of Documentation (APD 2.0) and future tools.
• Assist providers in navigating coding workflows, resolving issues, and ensuring successful use of coding tools.
• Monitor and support completion of coding activities tied to assigned providers.
• Participate in a daily coder helpdesk (virtual/Zoom-based), providing real-time support to providers within assigned markets.
• Address immediate coding and documentation questions, ensuring accurate guidance and maintaining high responsiveness.
• Support HCC outage management through structured reviews of “assessed but not coded” conditions.
• Conduct targeted reviews to identify missed coding opportunities and provide education to improve recapture performance.
• Collaborate with analytics and leadership teams to track and improve performance outcomes.

Requirements

• 3+ years of risk adjustment Medical Coding or risk adjustment Provider Education experience.
• Intermediate/advanced competency with MS Office-based programs (Excel, Word, PowerPoint).
• Certified in at least one of the following: CCS, CRC, or CPC.
• Must reside and be able to travel within the assigned MSO market or region (Deland, FL 32720).
• Ability to travel locally for in-office provider support; occasional (quarterly) travel within the market may be required.
• In-center presence required, involving daily commute to assigned clinic(s).
• Must reside within 50 miles of Deland, FL 32720.
• Valid state driver’s license and personal vehicle liability insurance (minimum $25,000 bodily injury per person/$25,000 bodily injury per event/$10,000 for property damage or state minimum requirements).
• Self-provided internet service with minimum download speed of 25 Mbps and upload speed of 10 Mbps (wired cable or DSL suggested; satellite, cellular, or microwave connections require leadership approval).
• Work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information.

Preferred Qualifications

• Strong communication and interpersonal skills for effective, clear, and sensitive engagement with clinicians and team members, even in high-pressure situations.
• Ability to present, influence, and build credibility at all levels of the organization.
• Positive, collaborative mindset with an ability to foster partnerships across Coding, Audit and Education, PCO, and Humana teams.

Schedule

• Monday–Friday, 8:00 AM–5:00 PM; additional time may be required as needed.
• Scheduled weekly hours: 40.
• Hybrid/remote workstyle.

Pay

The pay range for this full-time (40 hours per week) position is $59,300 - $80,900 per year. Compensation may vary based on geographic location and individual qualifications, including skills, knowledge, experience, education, and certifications. This role is also eligible for a bonus incentive plan based on company and/or individual performance.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, including company and personal holidays, paid parental and caregiver leave.
• Short-term and long-term disability.
• Life insurance.
• Employees in California, Illinois, Montana, or South Dakota will receive a bi-weekly payment for internet expenses.
• Company-provided telephone equipment to meet business requirements.

About the Role

This role is considered patient-facing and requires Tuberculosis (TB) screening. It is part of Humana’s driver safety program, requiring a valid state driver’s license and maintenance of personal vehicle liability insurance.

About Us

CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, and minor injury treatment. Our care model focuses on personalized experiences, addressing physical, emotional, and social wellness factors. Integrated care teams spend up to 50% more time with patients, delivering compassionate, personalized care for better health outcomes.

CenterWell, a Humana company, is a leading healthcare services business creating integrated and differentiated experiences. As the largest provider of senior-focused primary care, a leading provider of home healthcare, and a top integrated home delivery, specialty, hospice, and retail pharmacy provider, CenterWell focuses on whole-person health. Learn more at CenterWell.com.