Medical Coding Manager

2 weeks ago


Raleigh, North Carolina, United States Humana Full time
Job Title: Medical Coding Manager

Humana is seeking a highly skilled Medical Coding Manager to lead our team of clinical coders in Payment Integrity. As a key member of our team, you will be responsible for reviewing clinical information from various medical records and advising on the appropriateness of procedural terminology and medical codes.

Key Responsibilities:
  • Lead a team of clinical coders in reviewing medical records and advising on coding decisions
  • Apply advanced technical knowledge to solve moderately complex problems
  • Work within specific guidelines and procedures to ensure accurate coding
  • Collaborate with cross-functional teams to ensure seamless operations
Requirements:
  • Minimum of an Associate's Degree
  • 5+ years of experience in medical auditing and coding with a focus on MS-DRG and APR-DRG
  • 2+ years of management experience in a highly matrixed operational setting
  • RHIA, RHIT, and/or CCS Certification
  • Experience with data analysis tools such as Power BI
Preferred Qualifications:
  • 6+ years of work experience related to claims with an understanding of claims lifecycles and healthcare revenue cycle management
  • Experience leading projects and/or processes
  • Experience in Financial Recovery
  • Experience with systems such as CAS, MTV, CISpro, and CIS
About Humana:

Humana is a leading health and well-being company that puts health first for our teammates, customers, and communities. We make it easier for millions of people to achieve their best health through our insurance services and CenterWell healthcare services.

Equal Opportunity Employer:

Humana is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive work environment that values diversity, equity, and inclusion.



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