Nurse Medical Coder

Humana · Montpelier, VT, United States

Location
Montpelier
Job Type
Full-time
Posted
June 27, 2026

Job Description

**Become a part of our caring community**
The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors.
**Key Responsibilities**
+ Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models
+ Validate diagnosis coding and ensure documentation meets compliance standards
+ Identify and escalate coding trends and documentation gaps
+ Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach

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