Become a part of our caring community and help us put health first.
The Inpatient Medical Coding Auditor extracts clinical information from various medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Work assignments involve moderately complex to complex issues requiring in-depth evaluation of situational factors.
Humana is seeking an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement and handle provider disputes in a metrics-driven environment. This remote position is with a Fortune 100 company focused on the well-being of consumers and staff.
This role contributes to cost reduction by increasing accuracy of provider contract payments, ensuring correct claims payment, and appropriate diagnosis related group (DRG) assignments. Responsibilities include analyzing and manipulating databases, clarifying medical information requests, and following established guidelines.
Work hours are Monday through Friday during typical business hours (6AM-6PM), with some flexibility. Occasional travel to Humana offices for training or meetings may be required.
The position is fully remote with requirements for a reliable internet connection, dedicated workspace, and provided telephone equipment to protect HIPAA information.
Humana offers competitive benefits including medical, dental, vision, 401(k), paid time off, parental leave, disability, life insurance, and other wellness programs.
Interview process includes pre-recorded voice or SMS text interviews using Hire Vue technology.
Equal Opportunity Employer committed to diversity and inclusion.
- RHIA, RHIT or CCS Certification held for at least 4 years
- Experience with MS-DRG coding/auditing
- Experience reading and interpreting claims
- Inpatient coding review/audit experience in health insurance or hospital settings
- Proficiency with Microsoft Office (Word, PowerPoint, Excel)
- Strong attention to detail
- Ability to work independently and manage multiple priorities
- Maintain confidentiality
- Excellent verbal and written communication skills
Preferred:
- APR DRG coding/auditing experience
- Experience in Financial Recovery
- Experience in fast-paced, metric-driven environment
Humana provides medical, dental, and vision benefits, 401(k) retirement plan, paid time off including holidays and parental leave, short-term and long-term disability, life insurance, and various wellness programs supporting whole-person well-being.
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Salary Range
$71,100 - $97,800
Remote work allowed
Yes
Posted
1 month ago