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The SIU clinical review team is looking for a Medical Coding Auditor. This position includes review of information provided in medical records and requires an understanding of what each line of business allows and restricts as appropriate. The coder will be required to have an in- depth knowledge of Evaluation & Management (E&M) codes. This will include knowledge of coding definitions and how they should be represented in the records.

The ideal candidate will be an avid learner with excellent research skills. In addition, this person will be able to communicate audit findings confidently to other medical and lay professionals both internal and external to Humana professionals.

The Medical Coding Auditor in this situation must analyze information given, research to gain additional knowledge, and work the review in the proper systems as necessary. 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, in often in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Use your skills to make an impact
 

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

WORK HOURS: Employees perform most work 5 days per week, 8 hours per day between 6AM-6PM in their home time zone.

We do not expect nor require early/late starts, weekends, evenings, or holidays.

Required Qualifications

• CPC Certification

• Acute outpatient coding experience

• Evaluation & Management billing or coding experience

• Excellent research skills

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

Preferred Qualifications

• Bachelor's degree

• Additional Evaluation & Management coding certification

• Behavioral health office experience

Work at Home Requirements

•            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 Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire 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.

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.

 

 

 

 

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