Behavioral Health Outpatient Medical Coding Auditor

🔥 4 minutes ago

🇺🇸 United States – Remote

💵 $59.3k - $80.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Humana

WebsiteLinkedInAll Job Openings

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

• Handle provider disputes in a result-oriented and metrics-driven environment • Focus on outpatient Behavioral Health coding disputes as part of the PPI Coding Disputes Team • Consult and collaborate with coding professionals within and across departments • Ensure accountability of coding dispute outcomes for timeliness, compliance, and quality • Ensure accuracy and compliance of coding dispute reviews by adhering to coding guidelines • Communicate dispute outcomes to providers professionally and concisely • Make coding decisions using standard industry guidelines and best practices • Manage multiple priorities and ensure timely completion of outpatient coding disputes • Report to the Manager • Participate in HireVue assessment during the hiring process

🎯 Requirements

• CPC or CCS Certification • CPT/HCPCS auditing experience • 1+ years' work experience reading and interpreting Behavioral Health claims • 3+ years' experience performing Behavioral Health coding audits in health insurance and/or hospital settings and working coding-related disputes and trending results • Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel • Ability to work independently and determine appropriate course of action • Excellent written and verbal communication skills • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Home internet with minimum download speed of 25 Mbps and upload speed of 10 Mbps • Wireless, wired cable, or DSL connection suggested; satellite, cellular, and microwave connections require leadership approval

🏖️ Benefits

• Health benefits effective day 1 • Paid time off, holidays, volunteer time and jury duty pay • Recognition pay • 401(k) retirement savings plan with employer match • Tuition assistance • Scholarships for eligible dependents • Parental and caregiver leave • Employee charity matching program • Network Resource Groups (NRGs) • Career development opportunities • Medical, dental and vision benefits • Short-term and long-term disability • Life insurance • Bonus incentive plan based upon company and/or individual performance • Internet expense payment for employees working from home in California, Illinois, Montana, or South Dakota