[Hiring] DME/Outpatient Medical Coding Auditor @Humana

Role Description

Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana.

• Reports to the Manager of the Disputes Team.
• Consults and collaborates with coding professionals within and across departments.
• Ensures high accountability of coding disputes outcomes for timeliness, compliance, and quality.
• Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines.
• Communicates disputes outcomes to providers in a professional and concise manner.
• Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices.
• Manages multiple priorities, collaborates with peers, and ensures timely completion of outpatient coding disputes.

Qualifications

• CPC or CCS Certification.
• CPT/HCPCS auditing experience.
• 1+ years' work experience reading and interpreting claims.
• 3+ years' experience performing DME coding audits in health insurance and/or hospital settings.
• Working knowledge of Microsoft Office Programs: Word, PowerPoint, and Excel.
• Can work independently and determine appropriate course of action.
• Excellent communication skills both written and verbal.

Requirements

• Associate's Degree or higher in Health Information Management (HIM) (preferred).
• Experience in Financial Recovery (preferred).
• Experience in a fast-paced, metric-driven operational setting (preferred).

Benefits

• Health benefits effective day 1.
• Paid time off, holidays, volunteer time, and jury duty pay.
• Recognition pay.
• 401(k) retirement savings plan with employer match.
• Tuition assistance.
• Scholarships for eligible dependents.
• Parental and caregiver leave.
• Employee charity matching program.
• Network Resource Groups (NRGs).
• Career development opportunities.

Additional Information

• Work-At-Home Requirements:
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps required.
  • Wireless, wired cable, or DSL connection is suggested.
  • Satellite, cellular, and microwave connection can be used only if approved by leadership.
  • Employees in specific states will receive a bi-weekly payment for their internet expense.
  • Humana will provide telephone equipment appropriate for the position.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.
• Scheduled Weekly Hours: 40.
• Pay Range: $59,300 - $80,900 per year, eligible for a bonus incentive plan based on performance.