Humana
10,000+ employees
Founded 1961
🏥 Healthcare
🛡️ Insurance
⚕️ Healthcare Insurance
Healthcare • Insurance • Healthcare Insurance
Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.
Senior Medical Coding Professional, Outpatient
🕒 2 days ago
🇺🇸 United States – Remote
💵 $71.1k - $97.8k / year
⏰ Full Time
🟠 Senior
🏥 Medical Billing and Coding
🦅 H1B Visa Sponsor
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Humana
10,000+ employees
Founded 1961
🏥 Healthcare
🛡️ Insurance
⚕️ Healthcare Insurance
Healthcare • Insurance • Healthcare Insurance
Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.
📋 Description
• Research claims anomalies to identify outpatient audit opportunities • Apply CPT/HCPCS coding guidelines and payer-specific rules • Analyze how codes impact reimbursement (APC grouping, edits, bundling) • Conduct detailed record to bill reviews • Validate appropriate code assignment and modifier usage • Document findings and support defensible audit determinations • Provide recommendations for recovery or education • Partner with clinical and analytics teams on audit strategies
🎯 Requirements
• CPC, COC, CCS, ROCC, RHIA, or RHIT Certification • 5+ years post certification experience with Outpatient Specialty Surgeries and Procedures • Knowledge of CPT/HCPCS coding • Experience reading and coding from operative reports
🏖️ Benefits
• medical, dental and vision benefits • 401(k) retirement savings plan • time off (including paid time off, company and personal holidays, paid parental and caregiver leave) • short-term and long-term disability • life insurance and many other opportunities
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