Humana

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review hospital claims for proper reimbursement and resolve provider disputes. You will extract clinical information and assign ICD-10-CM, ICD-10-PCS and DRG codes to patient records, ensuring accurate payments. Responsibilities include reviewing inpatient records, auditing coding quality, resolving disputes with a fact-based approach, and collaborating with cross-functional teams to improve payment accuracy and #J-18808-Ljbffr

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. You will extract clinical information, assign ICD-10-CM, ICD-10-PCS, and DRG codes, and analyze coding scenarios to ensure accurate payment and contract alignment. Responsibilities include reviewing records, auditing coding quality, and collaborating with teams to improve payment accuracy and reduce errors, with travel as #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review hospital inpatient claims for accurate reimbursement and to resolve provider disputes. You will extract clinical information and assign ICD-10-CM, ICD-10-PCS, and DRG codes, ensuring proper payments. The role emphasizes accuracy, collaboration with multiple teams, and cost reduction through improved payment integrity. Remote work with potential travel for training or meetings, 40 hours per week. #J-18808-Ljbffr

Humana, a Fortune 100 Company, is seeking an experienced and Certified Inpatient Medical Coding Auditor to review hospital claims for proper reimbursement and resolve provider disputes. You will extract clinical information from medical records, assign ICD-10-CM/PCS and DRG codes, audit coding quality, and collaborate with teams to improve payment accuracy and reduce errors. This remote position offers a competitive bonus plan and comprehensive benefits. #J-18808-Ljbffr

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM/ICD-10-PCS and DRG codes, and resolve provider disputes. The role focuses on accuracy of hospital claim payments and contract payments within payer systems. Responsibilities include auditing inpatient records, investigating disputes, and collaborating with teams to improve coding quality. Remote position with potential travel for training, Monday–Friday hours. #J-18808-Ljbffr

Become a part of our caring community The Senior Medical Coding Professional, Inpatient supports payment integrity initiatives by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity. Key Responsibilities 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 Use your skills to make an impact Required Qualifications Required: RHIA, RHIT, CCS, or CIC 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 Preferred Qualifications 3M...

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review hospital inpatient claims, assign ICD-10-CM/PCS and DRG codes, and resolve provider disputes. The role focuses on accuracy of reimbursements and DRG assignments. This remote position requires 4+ years of MSDRG coding auditing, certification (RHIA/RHIT/CCS), and experience in inpatient coding audits within health plans or hospitals. #J-18808-Ljbffr

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Humana Inc. seeks a Senior Medical Coding Professional, Inpatient to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity. You will review records, identify anomalies for audits, apply ICD-10-CM/PCS guidelines, assess reimbursement impact, and collaborate with clinical reviewers. The role offers a home or hybrid work option and a comprehensive benefits package. #J-18808-Ljbffr

Become a part of our caring community Become a part of our caring community and help us put health first The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating...

Medical Coding Professional 2 The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, you will be assigned a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review hospital claims for accurate reimbursement and to resolve provider disputes. The role involves assigning ICD-10-CM, ICD-10-PCS, and DRG codes, with a focus on payment accuracy. This remote position requires 4+ years of inpatient coding auditing, RHIA/RHIT/CCS certification, and experience in health insurance or hospital settings. #J-18808-Ljbffr

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review hospital claims for proper reimbursement and DRG assignments. You will extract clinical data and ensure accurate ICD-10-CM/PCS codes and compliance. The role is remote, with standard 40-hour weeks and potential travel to Humana offices as needed. Candidates should have 4+ years of inpatient coding audits, RHIA/RHIT/CCS certification, and strong claims-reading skills, contributing to cost savings and #J-18808-Ljbffr

Humana Inc. seeks an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. The role involves extracting clinical information, assigning ICD-10-CM, ICD-10-PCS, and DRG codes, and auditing coding quality to ensure accurate payments. Responsibilities include reviewing records, investigating disputes, and collaborating with teams to improve payment accuracy. #J-18808-Ljbffr

Humana Inc. is looking for an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. The role focuses on ICD-10-CM, ICD-10-PCS, and DRG code assignments to ensure accurate payments and cost control. Work hours are Monday–Friday, with a remote arrangement; travel to Humana offices may be required occasionally. Eligible for a bonus plan and comprehensive benefits including medical, dental, vision, and a #J-18808-Ljbffr

Humana, Inc. is seeking a Senior Medical Coding Professional, Inpatient to support payment integrity by reviewing inpatient records for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity. You will collaborate with clinical reviewers and data analysts to identify anomalies, conduct retrospective audits, and document findings. Strong DRG knowledge and CDI/SOI concepts are essential, with 5+ years inpatient coding experience #J-18808-Ljbffr

A leading health insurance company is seeking an Inpatient Medical Coding Auditor to extract and analyze clinical information from patient records, ensuring proper coding for reimbursement. This remote position requires a certification (RHIA, RHIT, or CCS) and experience with coding/auditing. The successful candidate will handle claims, contribute to cost reduction, and must have excellent communication skills. The role offers a competitive salary range of $71,100 to $97,800 per year along with a comprehensive benefits package. #J-18808-Ljbffr

Humana, a Fortune 100 company, is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. You will extract clinical information and assign ICD-10-CM, ICD-10-PCS, and DRG codes to patient records. Responsibilities include reviewing records for accurate coding, auditing coding quality, collaborating with teams, and contributing to cost savings by improving payment accuracy. #J-18808-Ljbffr

Humana Inc, a Fortune 100 company, seeks an experienced Certified Inpatient Medical Coding Auditor to review hospital claims for proper reimbursement and DRG assignments. You will extract clinical information and assign ICD-10-CM, ICD-10-PCS, and DRG codes while supporting cost reduction through accurate payments. The role emphasizes auditing inpatient coding, resolving provider disputes, and collaborating with teams to improve payment accuracy. #J-18808-Ljbffr

Become a part of our caring community The Senior Medical Coding Professional, Inpatient supports payment integrity initiatives by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity. Key Responsibilities 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 Use your skills to make an impact Required Qualifications Required: RHIA, RHIT, CCS, or CIC 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 Preferred Qualifications 3M...

Humana Inc. seeks an IPA Consultative Coding Professional to provide medical coding expertise and consultative support to IPA affiliates nationwide. You will serve as the primary coding resource for assigned providers, ensuring accurate documentation and risk adjustment capture while collaborating with STARS leaders. You will manage a panel of up to 30 providers, deliver ongoing education, support coding workflows, and help align documentation with coding standards across the organization. #J-18808-Ljbffr