Inpatient Medical Coding Auditor

🔥 18 hours ago

🇺🇸 United States – Remote

💵 $71.1k - $97.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🏥 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

• Review appropriate DRG and ICD-10-CM/PCS coding assignments for accuracy within the appeals team • Consult and collaborate with coding professionals within and across departments on coding disputes • Ensure accountability of coding dispute outcomes for timeliness, compliance, and quality • Conduct inpatient coding audits involving MSDRG/APDRG • Ensure accuracy and compliance of coding appeal reviews using applicable coding guidelines • Communicate appeals outcomes to providers professionally and concisely • Make coding decisions based on industry guidelines and best practices • Manage multiple priorities and ensure timely completion of inpatient coding appeals • Report to the Manager

🎯 Requirements

• RHIA, RHIT, or CCS Certification • At least 2 years' experience in acute in-patient coding experience and/or MS-DRG auditing • Recent experience auditing using CMS Manual, LCD, NCD, and Coding Guidelines • Experience reading and interpreting claims • Excellent written and verbal communication skills • Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel • Strong attention to detail • Ability to work independently and determine appropriate course of action • Passion for contributing to an organization focused on continuously improving consumer experiences • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Internet connection with minimum download speed of 25 Mbps and upload speed of 10 Mbps • Ability to start each workday between 6AM–9AM EST • Occasional travel to Humana offices for training or meetings may be required

🏖️ 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 employees working from home in California, Illinois, Montana, or South Dakota • Telephone equipment appropriate to business requirements • Remote work from home • HireVue interview scheduling flexibility