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

The Inpatient 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. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Where you Come In 
Humana is looking for an experienced medical coding auditor to (suggest: review inpatient hospital claims for proper reimbursement) handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG)

The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. 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.

What Humana Offers 
We are fortunate to offer a remote opportunity for this job.  Our Fortune 100 Company values associate engagement & your well-being.  We also provide excellent professional development & continued education.  

This is a 40 hour per week role and the work hours will be 8 hours a day Monday to Friday 
 

Use your skills to make an impact
 

Required Qualifications – What it takes to Succeed
•   RHIA, RHIT or CCS Certification (should have held at least one of these qualifications for 4 years)

•    MS-DRG coding/auditing experience

•    Minimum of 1 years' work experience reading and interpreting claims

•    Minimum of 3 years’ experience in performing inpatient coding reviews/ audits in health insurance and/or hospital settings

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

•    Strong attention to detail

•    Can work independently and determine appropriate course of action

•    Ability to handle multiple priorities

•    Capacity to maintain confidentiality

•    Excellent communication skills both written and verbal

Preferred Qualifications
•    Experience in APR DRG coding/ auditing

•    Experience in Financial Recovery

•    Experience in a fast paced, metric driven operational setting

Additional Information - How we Value You  
•    Benefits starting day 1 of employment 
•    Competitive 401k match  
•    Generous Paid Time Off accrual  
•    Tuition Reimbursement 
•    Parent Leave 
 

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 recommended; wireless, wired cable or DSL connection is suggested

·             Satellite, cellular and microwave connection can be used only if approved by leadership

·             Associates 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

Interview Format

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 from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay