IPA Consultative Coder - Treasure Coast (Port St. Lucie / Fort Pierce)

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 be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives.

About the role

As an IPA Consultative Coding Professional, you will be assigned a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. You will collaborate with STARS leaders and champions to identify STARS gaps and deficiencies.

Responsibilities

• Be 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 and opportunities identified through chart reviews and coding analytics.
• Conduct quarterly chart reviews for assigned providers 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, and partner 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 any future tools implemented based on organizational needs.
• 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.
• Maintain a high level of responsiveness and provider engagement.
• 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.
• 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 (Port St. Lucie, FL 34952).

Preferred Qualifications

• Strong communication and interpersonal skills to enable effective, clear, and sensitive engagement with clinicians and team members, even in high-pressure or stressful situations.
• Positive, collaborative mindset with an ability to foster partnerships across Coding, Audit and Education, PCO, and Humana teams.

Work Information

• This role requires an in-center presence, involving daily commute to assigned clinic(s) and occasional (quarterly) travel within the market to alternative clinic(s) for strategic meetings.
• Hybrid/remote workstyle.
• Must reside within 50 miles of Port St. Lucie, FL 34952.
• Hours: Monday–Friday, 8:00 AM–5:00 PM; additional time may be required.
• This role is considered patient facing and requires TB screening.
• Requires a 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).
• Home internet service must meet minimum criteria: download speed of 25 Mbps and upload speed of 10 Mbps (wireless, wired cable, or DSL connection suggested).

Pay

The pay range for this full-time (40 hours per week) position is $59,300 - $80,900 per year. This job is eligible for a bonus incentive plan based on company and/or individual performance.

Benefits

Humana offers competitive benefits that support whole-person well-being, including:

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off (including paid holidays, company holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life 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 unique care model focuses on personalized experiences, taking time to listen, learn, and address the factors that impact patient well-being. Our integrated care teams spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes.

CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put patients at the center of everything we do. As part of Humana Inc. (NYSE: HUM), CenterWell is the largest provider of senior-focused primary care, a leading provider of home healthcare, and a leading integrated home delivery, specialty, hospice, and retail pharmacy.