Humana
Juneau, AK, USA
Become a part of our caring community and help us put health first
The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines
Utilize encoders and various coding resources
Perform CPT Procedure reviews...