Senior Medical Coding Professional, Inpatient

🔥 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

🟠 Senior

🏥 Medical Billing and Coding

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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 records for coding accuracy and DRG validation • Identify anomalies for audit targeting • Apply ICD-10-CM/PCS coding guidelines and DRG logic • Assess how coding impacts reimbursement and severity adjustment • Conduct retrospective audits and document findings • Recommend adjustments, recoveries, or provider education • Collaborate with clinical reviewers and data analysts

🎯 Requirements

• RHIA, RHIT, CCS, or CIC certification • 5+ years inpatient coding experience • Audit or validation experience • Strong DRG knowledge (MS-DRG/APR-DRG) • Understanding of CDI and severity of illness (SOI/ROM) concepts • 3M Coding software experience (preferred) • BA degree (preferred) • Previous leadership experience (preferred)

🏖️ Benefits

• 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 • Bonuses based on company and individual performance