Medical Coding Auditor

About this role

Become a part of our caring community   The Medical Coder 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. The Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.

The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates databases. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. 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 correct coding guidelines are met

• Perform CPT/HCPCS code reviews for professional Evaluation and Management services: Inpatient, Office, ER, Telehealth, Home Health, Behavioral health and/or minor procedures

• Maintain productivity metrics

• Must maintain quality metrics

• Utilize encoders and various coding resources

• Maintain current working knowledge of ICD-10 and CPT coding principles, government regulation, protocols

• Maintain strict patient and physician confidentiality

Use your skills to make an impact   WORK STYLE: Remote, work at home. While this is a remote position, 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. Once training is completed, associates may start as early as 6AM in their own time zone, depending on business needs.

Required Qualifications • CPC, CCS, COC, RHIA, or RHIT Certification either through AAPC or AHIMA

• Minimum of 3 years post-certification experience auditing Professional Evaluation & Management (E&M) Services - Inpatient, Office, ER, Telehealth, Home Health, Behavioral health and/or minor procedures

• Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel

• Can work independently and determine appropriate courses of action

Preferred Qualifications • Bachelor's Degree

• 3 or more years of experience as a certified medical coder

Additional Information Work at Home Requirements •            At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested •            Satellite, cellular and microwave connection can be used only if approved by leadership •            Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. •            Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. •            Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.   Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  

Scheduled Weekly Hours

40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.   $53,100 - $72,500 per year  

Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k)

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