Description
The Medical Coding Coordinator reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery.
The Medical Coding Coordinator 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.
Analyses, enters and manipulates database. Responds to or clarifies internal requests for medical information.
Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects.
Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience and depth of knowledge of administrative processes and organisational knowledge.
Responsibilities
- Extract clinical information from medical records and assign procedural terminology and medical codes
- Analyse, enter and manipulate database
- Respond to internal requests for medical information
- Exercise discretion and judgment in prioritising requests and interpreting procedures
Requirements
- Coding Certification: AAPC CPC (no Apprentice)
- Minimum of 3 years' experience as a Certified Medical Coder
- Demonstrate ability to problem-solve complex coding issues
- Experience with Medicare and Medicaid coding guidelines
- Strong data entry and attention to detail skills with the ability to manage multiple tasks in a fast-paced setting with competing priorities
- Intermediate experience with Microsoft Word and Excel, Outlook, and Teams
Preferred Qualifications
- Bachelor's Degree
- 5 or more years of experience as a Certified Medical Coder
- CPMA certification
- MS-DRG auditing or APR auditing experience
- Experience in a production-driven environment
What Humana Offers
- Competitive benefits that support whole-person well-being
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- Short-term and long-term disability
- Life insurance
Work Style
- Remote, work at home
- Occasional travel to Humana's offices for training or meetings may be required
Work Hours
- Typical business hours are Monday-Friday, 8 hours/day, 5 days/week