Join Our Compassionate Team and Make a Difference in Healthcare!
The Inpatient Coding Auditor plays a crucial role in extracting clinical information from medical records and accurately assigning procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient files. This position addresses complex issues that require thorough analysis and evaluation of various factors.
At Humana, we are searching for a skilled medical coding professional to assess inpatient hospital claims to ensure correct reimbursement and to handle disputes with providers effectively. If you are looking for a remote role with a prestigious company that prioritizes the well-being of its members and employees while recognizing outstanding performance, this position might be perfect for you.
This role significantly contributes to reducing costs by ensuring the accuracy of provider contract payments and facilitating appropriate claims payments alongside accurate diagnosis-related group (DRG) assignments. Key responsibilities include analyzing, entering, and managing databases, as well as responding to internal requests for medical information as needed. A strong grasp of departmental and organizational goals is essential, along with the ability to make independent decisions regarding work methodologies.
Utilize Your Expertise to Make a Positive Impact!
Required Qualifications | Skills for Success
- RHIA, RHIT, or CCS Certification (4 years of certification)
- MS-DRG coding/auditing experience
- Ability to read and interpret claims
- Inpatient coding review/audit experience in health insurance or hospital settings
- Proficiency in Microsoft Office programs (Word, PowerPoint, Excel)
- Strong attention to detail
- Independent decision-making skills
- Ability to manage multiple priorities
- Maintain confidentiality
- Excellent written and verbal communication skills
Preferred Qualifications
- Experience in APR DRG coding/auditing
- Background in Financial Recovery
- Experience in fast-paced, metrics-driven operational environments
Additional Information
Work from Home Requirements:
Minimum internet download speed of 25 Mbps and upload speed of 10 Mbps required; wired cable or DSL is recommended. Associates in California, Illinois, Montana, or South Dakota will receive bi-weekly internet expense payments. Humana will provide necessary telephone equipment. Work from a dedicated, quiet space to protect member PHI/HIPAA information.
Interview Format:
Our hiring process may include utilizing the Hire Vue platform for an engaging interview experience. If selected, you will participate in a pre-recorded voice interview or an SMS text messaging interview, which will take approximately 10-15 minutes. Your responses will be evaluated as part of the selection process.
Scheduled Weekly Hours: 40
Pay Range: Compensation ranges from $71,100 - $97,800 per year, based on geographic location and individual qualifications. Bonus incentives may be available based on performance.
Description of Benefits:
Humana offers competitive benefits focused on overall well-being, including medical, dental, and vision coverage, 401(k) plans, paid time off, short-term and long-term disability, life insurance, and more.
Application Deadline: 12-25-2040
About Humana:
Humana Inc. is dedicated to prioritizing health for everyone we serve, from our teammates and customers to the broader community. Through comprehensive insurance services and healthcare solutions, we facilitate better health outcomes and improved quality of life for our clients.
Equal Opportunity Employer:
Humana is committed to diversity and does not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status.