[Hiring] Inpatient Medical Coding Auditor @Humana

Role Description

Become a part of our caring community. The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/PCS coding assignments for accuracy within the coding disputes team from a variety of medical records.

• The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality.
• Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG).
• Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and 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 inpatient coding disputes.

Qualifications

• RHIA, RHIT or CCS Certification (have held at least one of these qualifications for 4 years).
• MS-DRG coding/auditing experience.
• 3+ years' experience performing inpatient coding reviews/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 APR DRG coding/auditing (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.

Company Description

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.

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance and many other opportunities.