Medical Coding Auditor – Outpatient

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $59.3k - $80.9k / 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 a variety of medical records • Assign appropriate procedural terminology and medical codes, including ICD-10-CM and CPT, to patient records • Interpret varied work assignments and independently determine appropriate courses of action • Audit outpatient medical records and claims • Handle and disseminate information with judgment and discretion • Work in a production-based environment and manage multiple priorities • Participate in pre-recorded voice and/or SMS text interviews during the hiring process • Occasionally travel to Humana offices for training or meetings

🎯 Requirements

• CPC, COC, CCS, RHIA, or RHIT Certification with a minimum of 3 years post-certification experience • Minimum of 2 years of outpatient medical record auditing experience • Knowledge of outpatient coding conventions and standards • Strong knowledge of NCD/LCDs, CMS Manual, NCCI Edits, and coding guidelines • Ability to exercise solid judgment and discretion in handling and disseminating information • Strong attention to detail • Ability to work independently and determine appropriate course of action • Ability to handle multiple priorities • Comfortable working in a production-based work environment • Ability to manage workload independently • Strong written and verbal communication skills • Strong analytical, organizational, and time management skills • Working knowledge of Microsoft Office programs, including Word and Excel • Associates are expected to start each workday between 6AM-9AM EST, regardless of home time zone • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Home internet with at least 25 Mbps download and 10 Mbps upload speed • Preferred: 5+ years prior coding experience; minimum 3 years reading and interpreting claims; outpatient facility auditing experience; 3M Coder software experience; CRM/SRO, Pareo, or MOAT experience; prior appeals and/or disputes auditing experience; financial recovery experience; fast-paced, metric-driven operational experience; advanced and/or specialty coding certifications

🏖️ 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 • Flexible start time may be possible after training, depending on business needs