Certified Inpatient Medical Coding Auditor

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $71.1k - $97.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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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

• Review inpatient medical records and claims for accurate coding and reimbursement • Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes • Audit coding quality and identify improvement opportunities • Investigate and resolve provider disputes using a fair, fact-based approach • Analyze complex clinical documentation and coding scenarios • Collaborate with other teams to clarify coding and medical information • Improve payment accuracy and reduce errors to contribute to cost savings • Extract clinical information from medical records and assign procedural terminology and medical codes to patient records

🎯 Requirements

• 4+ years of MSDRG coding auditing experience • RHIA, RHIT, or CCS certification, held for at least 4 years • Experience performing inpatient coding audits in a health insurance or hospital setting • Experience reading and interpreting claims • Proficiency in gathering or referencing data within different systems simultaneously • Preferred: experience in APDRG coding/auditing • Preferred: experience in Financial Recovery • Preferred: experience in a metric-driven operational setting • Minimum download speed of 25 Mbps and upload speed of 10 Mbps for home work • Work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Home-based work arrangement • Occasional travel to Humana offices for training or meetings