Medical Coding Auditor
This role is part of the SIU clinical review team and involves reviewing medical records to ensure accurate application of Evaluation & Management (E&M) coding, understanding line‑of‑business constraints, and communicating audit findings to internal and external stakeholders.
Responsibilities
• Review and analyze medical records for coding accuracy.
• Research coding definitions and apply them consistently.
• Enter audit findings into the appropriate systems.
• Respond to internal requests for additional medical information.
• Apply organizational strategy and guidelines to ambiguous situations with minimal direction.
• Communicate results confidently to medical and lay professionals.
Work Style
Remote, work‑from‑home. Occasional travel to Humana’s offices may be required for training or meetings.
Work Hours
Employees work 5 days per week, 8 hours per day between 6 AM‑6 PM in their home time zone. Early or late starts, weekends, evenings, or holidays are not required.
Required Qualifications
CPC Certification
Acute outpatient coding experience
Evaluation & Management billing or coding experience
Excellent research skills
Passion for improving consumer experiences
Preferred Qualifications
Bachelor’s degree
Additional E&M coding certification
Behavioral health office experience
Work at Home Requirements
Minimum download speed of 25 Mbps and upload speed of 10 Mbps.
Wireless, wired, cable or DSL connection is recommended.
Satellite, cellular, and microwave connections only if approved.
Associates in California, Illinois, Montana, or South Dakota receive bi‑weekly payment for internet expenses.
Humana provides telephone equipment as needed.
Work from a dedicated space with no interruptions to protect PHI / HIPAA.
Pay Range
From $59,300 to $80,900 per year. Bonus incentive plan may apply.
Description of Benefits
Humana offers medical, dental, vision, 401(k), paid time off, holidays, volunteer time off, parental and caregiver leave, short‑term and long‑term disability, life insurance, and more.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against employees or applicants for employment based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. Humana is committed to affirmative action and complies with all applicable federal civil rights laws.
Humana provides free language interpreter services. See https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
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