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The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the coding disputes team from a variety of medical records.

The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality.

• Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG)
• Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner.
• Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices
• Manages multiple priorities, collaborates with peers and ensures timely completion of inpatient coding disputes

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

Use your skills to make an impact
 

WORK STYLE: Work at home, remote. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

WORK HOURS: Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. Some flexibility might be available, depending on business needs.

Required Qualifications

• RHIA, RHIT or CCS Certification (have held at least one of these qualifications for 4 years)
• MS-DRG coding/auditing experience
• 3+ years' experience performing inpatient coding reviews/ audits in health insurance and/or hospital settings
• Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
• Can work independently and determine appropriate course of action
• Excellent communication skills both written and verbal

Preferred Qualifications

• Associate's Degree or higher in Health Information Management (HIM)
• Experience in APR DRG coding/auditing
• Experience in Financial Recovery
• Experience in a fast paced, metric driven operational setting

Additional Information

Work-At-Home Requirements

• To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Our Hiring Process

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected, you will receive correspondence inviting you to participate in a HireVue assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 10-15 minutes. Your answers will be reviewed, and you will subsequently be informed if you will be moving forward to next round.

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Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download sp