Certified Inpatient Medical Coding Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct thorough reviews of inpatient medical records and claims to ensure accurate coding and reimbursement.

• Assign and verify ICD-10-CM, ICD-10-PCS, and DRG codes.

• Perform audits on coding quality and pinpoint areas for improvement.

• Address and resolve provider disputes using a balanced, evidence-based approach.

• Analyze intricate clinical documentation and coding situations.

• Collaborate with various teams to clarify medical information and coding details.

• Enhance payment accuracy and minimize errors to aid in cost-saving efforts.

• Extract clinical information from medical records and allocate procedural terminology and medical codes to patient files.

⛳️ Requirements

• A minimum of 4 years of experience in MSDRG coding auditing.

• RHIA, RHIT, or CCS certification, maintained for at least 4 years.

• Proven experience in conducting inpatient coding audits within a health insurance or hospital environment.

• Skilled in reading and interpreting claims.

• Proficient in collecting or referencing data across multiple systems simultaneously.

• Preferred: experience in APDRG coding/auditing.

• Preferred: experience in Financial Recovery.

• Preferred: background in a metric-driven operational context.

• Required minimum download speed of 25 Mbps and upload speed of 10 Mbps for remote work.

• Must work from a designated space free from interruptions to safeguard member PHI/HIPAA information.

🏝️ Benefits

• Bonus incentive plan.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Home-based work arrangement.

• Occasional travel to Humana offices for training or meetings.