Inpatient Medical Coding Auditor

🔥 0 minutes ago

🏄 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

🔎 Auditor

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

⚕️ 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 to ensure accurate coding and reimbursement • Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes • Audit coding quality and identify opportunities for improvement • Investigate and resolve provider disputes with a fair, fact-based approach • Analyze complex clinical documentation and coding scenarios • Collaborate with other teams to clarify coding and medical information • Contribute to cost savings by improving payment accuracy and reducing errors

🎯 Requirements

• Four or more years of MSDRG coding auditing experience • RHIA, RHIT or CCS Certification (must have held certification 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

🏖️ Benefits

• medical, dental and vision benefits • 401(k) retirement savings plan • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) • short-term and long-term disability • life insurance