Inpatient Medical Coding Auditor

Description

The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records.

Responsibilities

The Medical Coding Auditor confirms appropriate diagnosis related group (DRG) assignments. This position will be a business partner with Resolution working Appeals from a clinical perspective to collaboratively complete appeal cases utilizing DRG knowledge. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information.

Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

WORK STYLE: 100% remote, work at home
WORK HOURS: Monday-Friday, 5 days/week, 8 hours per day. Must start between 6AM-9AM EST.

Required Qualifications

• RHIA, RHIT, or CCS Certification

• At least 2 years of MS-DRG auditing

• At least 2 years of acute in-patient coding experience

• At least 2 years of recent experience auditing using CMS Manual, LCD, NCD, and Coding Guidelines

• Minimum of 1 year work experience reading and interpreting claims

• Excellent written and verbal communication skills

• Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel

• Strong attention to detail

• Can work independently and determine appropriate course of action

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

Preferred Qualifications

• Associate's Degree or higher in Health Information Management (HIM)

• Experience in Financial Recovery

• Experience in a fast paced, metric driven operational setting

• Experience in APR DRG coding/ auditing

ADDITIONAL INFORMATION

Work at Home Requirements

•    WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

•    A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.  

•    Satellite and Wireless Internet service is NOT allowed for this role.

•    A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
 

Additional Information - How We Value You  

•    Benefits starting day 1 of employment 

•    Competitive 401k match  

•    Generous Paid Time Off accrual  

•    Tuition Reimbursement 

•    Parental Leave 
 

Interview Format 

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

#ThriveTogether #WorkAtHome

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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$57,700 - $79,500 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support who