Inpatient Medical Coding Auditor

🔥 0 minutes ago

🇺🇸 United States – 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.

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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, 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 department, segment, and organizational strategy and operating objectives • Make decisions regarding work methods, occasionally in ambiguous situations • Follow established guidelines and procedures • Participate in occasional travel to Humana offices for training or meetings

🎯 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 • Recommended minimum internet speed of 25 Mbps download and 10 Mbps upload; 25 Mbps download and 10 Mbps upload required in later work-at-home requirements • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information • Preferred: Experience in APR DRG coding/auditing • Preferred: Experience in Financial Recovery • Preferred: Experience in a fast-paced, metric-driven operational setting

🏖️ Benefits

• Bonus incentive plan based on 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 • Humana-provided telephone equipment for Home or Hybrid Home/Office associates • Remote/work-at-home arrangement • Flexible scheduling may be possible depending on business needs