Medical Coding Auditor

🔥 13 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.

👻 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

• Verify and ensure the accuracy, completeness, specificity, and appropriateness of procedure codes based on services rendered • Review medical documentation for clinical indicators and correct APC and Outpatient Facility coding • Utilize encoders and various coding resources • Perform CPT/HCPCS procedure reviews • Conduct peer reviews for coding guideline compliance and provide reports as needed • Maintain patient and physician confidentiality and follow federal, state, and hospital release-of-information guidelines • Maintain current knowledge of ICD-10 and CPT coding guidelines, government regulations, and protocols • Complete system entries for claim/encounter information • Support and participate in process and quality improvement initiatives • Analyze, enter, and manipulate databases • Respond to or clarify internal requests for medical information • Contribute to cost reduction and accurate provider contract payments and claims payment

🎯 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 Outpatient Specialty Surgeries and Procedures • Strong knowledge of CPT/HCPCS coding • Experience reading & coding from operative reports • Chemotherapy and/or Therapeutic Infusion experience • Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information • Strong attention to detail, ability to work independently, determine appropriate course of action, and handle multiple priorities • Comfortable working in a production-based work environment • Ability to work independently and manage workload • Strong written and verbal communication skills; strong analytical, organizational and time management skills • Working knowledge of Microsoft Office Programs (Word, Excel) • Minimum 25 Mbps download and 10 Mbps upload internet connection recommended/required for home work • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based upon 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 • Telephone equipment provided as appropriate for business requirements