Become a part of our caring community and help us put health first

The Risk Adjustment Representative 3 is responsible for contacting provider offices to obtain medical records and/or set up onsite visits for Record Retrieval Specialists to retrieve medical records. The Risk Adjustment Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

The Risk Adjustment Representative 3 (Scheduler) ensures sites with open medical records requests are contacted in order for Humana to obtain a copy of records. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge. Candidate may be asked to travel locally for record retrieval assistance at provider offices or hospitals if there is a business need.

• Min # of phone calls per day to assigned list of providers

• Management of sites assigned and tracking of records received to a specified goal

• Document progress/calls made daily/complete daily productivity report

• Research site information/update information internally

Use your skills to make an impact

Required Qualifications

• High School Diploma

• 1 or more years of Customer Service experience

• Proficiency in Microsoft Office applications: Word and Excel

• Must have reliable transportation

• This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

• Strong written and verbal communication skills

• Organizational and time management skills

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Knowledge of ICD-9/10 coding

• Medical record terminology

• Knowledge and experience in health care environment/managed care (provider office, billing, coding, medical records, etc.)

Additional Information

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$43,000 - $56,200 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 04-28-2025

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

​
Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.