Medical Coding Auditor

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $53.1k - $72.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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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 medical documentation for clinical indicators to ensure correct coding guidelines are met • Perform CPT/HCPCS code reviews for professional Evaluation and Management services, including Inpatient, Office, ER, Telehealth, Home Health, Behavioral health, and minor procedures • Confirm correct CPT coding assignments • Analyze, enter, and manipulate databases • Respond to or clarify internal requests for medical information • Maintain productivity metrics • Maintain quality metrics • Utilize encoders and various coding resources • Maintain current working knowledge of ICD-10 and CPT coding principles, government regulations, and protocols • Maintain strict patient and physician confidentiality • Work independently, making decisions regarding work methods and appropriate courses of action • Work typical Monday-Friday business hours, 8 hours per day, 5 days per week

🎯 Requirements

• CPC, CCS, COC, RHIA, or RHIT certification through AAPC or AHIMA • Minimum of 3 years post-certification experience auditing Professional Evaluation & Management (E&M) Services • Auditing experience covering Inpatient, Office, ER, Telehealth, Home Health, Behavioral health and/or minor procedures • Working knowledge of Microsoft Office programs, including Word, PowerPoint, and Excel • Ability to work independently and determine appropriate courses of action • Minimum download speed of 25 Mbps and upload speed of 10 Mbps • Wireless, wired cable, or DSL internet connection suggested; satellite, cellular, and microwave connections require leadership approval • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Ability to work Monday-Friday, 8 hours per day, 5 days per week • Ability to start as early as 6 AM in own time zone after training, depending on business needs • Bachelor's degree preferred • 3 or more years of experience as a certified medical coder preferred

🏖️ Benefits

• Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Internet expense payment for associates who live and work from home in California, Illinois, Montana, or South Dakota • Humana-provided telephone equipment for Home or Hybrid Home/Office associates • Remote work at home • Occasional travel to Humana offices for training or meetings