Medical Coding Auditor

🕒 September 2

🇺🇸 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.

👻 Ghost score 24%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 claims against medical records to ensure correct coding guidelines are met • Verify accuracy, completeness, specificity, and appropriateness of procedure codes based on services rendered • Review medical documentation for clinical indicators and coding compliance specific to APC and outpatient facility coding • Utilize encoders and coding resources • Perform CPT/HCPCS procedure reviews • Conduct peer reviews and provide reports as needed • Maintain patient and physician confidentiality and follow federal, state, and hospital information-release guidelines • Maintain current knowledge of ICD-10 and CPT coding guidelines, government regulations, and protocols • Complete system entries for claim and encounter information • Support process and quality improvement initiatives • Analyze, enter, and manipulate database information • Respond to or clarify internal requests for medical information • Work independently, make decisions regarding work methods, and follow established procedures

🎯 Requirements

• CPC, COC, CCS, ROCC, RHIA, or RHIT certification with a minimum of 3 years post-certification experience • Minimum of 3 years post-certification experience in outpatient specialty surgeries and procedures • Strong knowledge of CPT/HCPCS coding • Experience reading and coding from operative reports • Chemotherapy and/or therapeutic infusion experience • Ability to exercise sound judgment and discretion in handling and disseminating information • Strong attention to detail and ability to work independently • Ability to handle multiple priorities • Comfortable working in a production-based work environment • Strong written and verbal communication skills • Strong analytical, organizational, and time management skills • Working knowledge of Microsoft Office programs, including Word and Excel • Ability to meet remote-work internet requirements: minimum 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions to protect PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Professional development and continued education • 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 appropriate to business requirements