[Hiring] Senior Medical Coding Professional @Humana

Role Description

The Senior Medical Coding Professional, Inpatient supports payment integrity initiatives by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity.

Key Responsibilities

• Review inpatient records for coding accuracy and DRG validation
• Identify anomalies for audit targeting
• Apply ICD-10-CM/PCS coding guidelines and DRG logic
• Assess how coding impacts reimbursement and severity adjustment
• Conduct retrospective audits and document findings
• Recommend adjustments, recoveries, or provider education
• Collaborate with clinical reviewers and data analysts

Qualifications

• Required: RHIA, RHIT, CCS, or CIC
• 5+ years inpatient coding experience
• Audit or validation experience
• Strong DRG knowledge (MS-DRG/APR-DRG)
• Understanding of CDI and severity of illness (SOI/ROM) concepts

Requirements

• 3M Coding software experience (preferred)
• BA degree (preferred)
• Previous leadership experience (preferred)

Benefits

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

Work-At-Home Requirements

• Minimum download speed of 25 Mbps and upload speed of 10 Mbps required
• Wireless, wired cable, or DSL connection suggested
• Satellite, cellular, and microwave connections can be used only if approved by leadership
• Employees in certain states will receive bi-weekly payment for internet expenses
• Must 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

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.

$71,100 - $97,800 per year

This job is eligible for a bonus incentive plan based on company and/or individual performance.

Application Deadline

07-24-2026

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.