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

The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

The Medical Coding Auditor confirms correct CPT coding 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.

• Review medical documentation for clinical indicators to ensure correct coding guidelines are met

• Perform CPT/HCPCS code reviews for professional Evaluation and Management services: Inpatient services, office visit services, ER, Consultation services, Annual Wellness Services, and minor procedures

• Utilize encoders and various coding resources

• Maintain current working knowledge of ICD-10 and CPT coding principles, government regulation, protocols

• Maintain strict patient and physician confidentiality

Use your skills to make an impact
 

WORK STYLE: Remote/Work at home
WORK HOURS: Associates will work on EST, regardless of where the associate resides. Work hours can vary slightly, but all associates start between 6AM-9AM EST. Some flexibility is available, depending on business needs.

 

Required Qualifications

• CPC, CCS, COC, RHIA, or RHIT Certification either through AAPC or AHIMA

• Minimum of 3 years post-certification experience auditing Professional Evaluation & Management Services - Inpatient, Office, ER, Telehealth, Home Health, and minor procedures

• Strong attention to detail

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

• Can work independently and determine appropriate courses of action

• Ability to handle multiple priorities

• Capacity to maintain confidentiality

• Excellent communication skills both written and verbal

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

 

Preferred Qualifications

• 5 years post-certification experience auditing Professional Evaluation & Management Services - Inpatient, Office, ER, Telehealth, Home Health, and minor procedures

• Experience with the Claims Life Cycle

• Experience with coding/auditing Professional Inpatient Claims

• Experience in Select Coder, 3M

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 or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$59,300 - $80,900 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 whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver