Inpatient Medical Coding Auditor

🕒 August 20

🏄 California, Illinois, +2 more states – Remote

🏄 California – Remote 🌽 Illinois – Remote 🦬 Montana – Remote 🗿 South Dakota – Remote

💵 $71.1k - $97.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 52%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Extract clinical information from medical records and assign appropriate procedural terminology and medical codes, including ICD-10-CM and CPT • Review inpatient hospital claims for proper reimbursement • Handle provider disputes in a result-oriented and metrics-driven environment • Increase accuracy of provider contract payments in payer systems • Ensure correct claims payment and appropriate DRG assignments • Analyze, enter, and manipulate database information • Respond to and clarify internal requests for medical information • Apply established guidelines and procedures • Work independently with minimal direction and make decisions regarding work methods • Participate in training or meetings at Humana offices when occasional travel is required

🎯 Requirements

• RHIA, RHIT or CCS Certification, held for at least 4 years • MS-DRG coding/auditing experience • Experience reading and interpreting claims • Experience performing inpatient coding reviews/audits in health insurance and/or hospital settings • Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel • Strong attention to detail • Ability to work independently and determine appropriate course of action • Ability to handle multiple priorities • Capacity to maintain confidentiality • Excellent written and verbal communication skills • Preferred: Experience in APR DRG coding/auditing • Preferred: Experience in Financial Recovery • Preferred: Experience in a fast-paced, metric-driven operational setting • Minimum 25 Mbps download and 10 Mbps upload internet service • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based upon company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Internet expense payment for associates working from home in California, Illinois, Montana, or South Dakota • Telephone equipment provided for Home or Hybrid Home/Office associates • Remote/work-at-home arrangement • Some flexibility in work schedule may be possible, depending on business needs

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