Inpatient Medical Coding Auditor

3 days ago


Denver, Colorado, United States Humana Full time
About the Role

We are seeking an experienced Medical Coding Auditor to join our team at Humana. As a Medical Coding Auditor, you will play a critical role in ensuring the accuracy and integrity of our medical coding processes.

Key Responsibilities
  • Extract clinical information from medical records and assign appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT)
  • Review inpatient hospital claims for proper reimbursement and handle provider disputes in a result-oriented and metrics-driven environment
  • Analyze, enter, and manipulate database information to ensure correct claims payment and appropriate diagnosis-related group (DRG) assignments
  • Respond to internal requests for medical information and understand department, segment, and organizational strategy and operating objectives
Requirements
  • RHIA, RHIT, or CCS certification with at least 4 years of experience
  • MS-DRG coding/auditing experience
  • Minimum 1 year of work experience reading and interpreting claims
  • Minimum 3 years of experience in performing inpatient coding reviews/audits in health insurance and/or hospital settings
  • Working knowledge of Microsoft Office programs (Word, PowerPoint, Excel)
What We Offer

As a Medical Coding Auditor at Humana, you will enjoy a competitive salary, comprehensive benefits package, and opportunities for professional growth and development. We also offer a remote work option, allowing you to work from the comfort of your own home.

Humana is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating a workplace that is inclusive and respectful of all employees.



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