Description
Humana is looking for an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement. As an Inpatient Medical Coding Auditor, you will extract clinical information from medical records and assign procedural terminology and medical codes to patient records. Your work will contribute to overall cost reduction by increasing the accuracy of provider contract payments and ensuring correct claims payment.
Responsibilities:
- Review inpatient hospital claims for proper reimbursement
- Analyze, enter, and manipulate databases
- Respond to internal requests for medical information
- Make decisions regarding own work methods with minimal direction
- Follow established guidelines and procedures
Requirements:
- RHIA, RHIT, or CCS certification (held for at least 4 years)
- MS-DRG coding/auditing experience
- Experience reading and interpreting claims
- Experience in performing inpatient coding reviews/audits in health insurance and/or hospital settings
- Working knowledge of Microsoft Office programs (Word, PowerPoint, Excel)
- Strong attention to detail
- Ability to work independently and handle multiple priorities
- Excellent communication skills (written and verbal)
Preferred Qualifications:
- Experience in APR DRG coding/auditing
- Experience in Financial Recovery
- Experience in a fast-paced, metric-driven operational setting
Work Style:
- Remote work arrangement with occasional travel to Humana's offices for training or meetings
- Typical business hours: Monday-Friday, 8 hours/day, 5 days/week, scheduled between 6AM-6PM
Benefits:
- Competitive benefits package, including 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
Pay Range: $71,100 - $97,800 per year