Inpatient DRG Quality Auditor
HumanaAbout the role
Become a part of our caring community and help us put health first
In this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus on DRG audits. You will also drive process improvement initiatives and develop educational materials. This is a full-time, remote/work-from-home position.Description
The Inpatient Medical Coding Auditor extracts clinical information from medical records and assigns appropriate codes (e.g., ICD-10-CM, CPT). This role involves analyzing moderately to highly complex issues requiring in-depth evaluation of variable factors.
Where you Come In
The Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the 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)
So, do you love working on several different projects? Do you take pride in helping others and being flexible? Do you pay great attention to detail and have a passion for healthcare? Do you have a solid background in medical auditing, coding, and medical record review? If you answered YES to one or more of the above, you should strongly consider this role.
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.
Use your skills to make an impact
WORK STYLE: 100% remote/work at home
WORK HOURS: Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Some flexibility might be possible, depending on business needs
Responsibilities
In this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus on DRG audits. You will also drive process improvement initiatives and develop educational materials. This is a full-time, remote/work-from-home position.
Required Qualifications
7+ years of DRG Coding
5 years of Quality Auditing
Medical coding certification from AHIMA (RHIT, CCS, CICA, CHCA)
Prior experience reading and coding from medical records.
Strong critical thinking skills.
Proficient in independently managing diverse priorities, adept at swiftly transitioning between tasks based on urgency and demand with minimal instruction.
Demonstrated ability to work independently and manage workload.
Exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence, and commitment to the profession.
Excellent writing, editing, interpersonal, planning, teamwork, and communication skills.
Proficient in MS Office applications including Word, Excel, Outlook, PowerPoint.
Apply for this role
Generate a tailored application kit with a matched cover letter, interview prep, and CV highlights — in under 60 seconds.
Apply Now →Generate Application KitFree account required — sign up in 30s