Inpatient Medical Coding Auditor

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

📋 Description

• Evaluate relevant DRG and ICD-10-CM/PCS coding assignments for precision within the appeals team.

• Collaborate and consult with coding specialists both within and across departments regarding coding disputes.

• Ensure accountability for the outcomes of coding disputes concerning timeliness, compliance, and quality.

• Perform inpatient coding audits that involve MSDRG/APDRG.

• Verify accuracy and compliance in coding appeal reviews by applying relevant coding guidelines.

• Professionally and succinctly communicate appeal outcomes to providers.

• Make coding decisions founded on industry standards and best practices.

• Handle multiple priorities while ensuring the timely completion of inpatient coding appeals.

• Report directly to the Manager.

⛳️ Requirements

• RHIA, RHIT, or CCS Certification is required.

• A minimum of 2 years of experience in acute inpatient coding and/or MS-DRG auditing.

• Recent experience with auditing utilizing CMS Manual, LCD, NCD, and Coding Guidelines.

• Proficient in reading and interpreting claims.

• Exceptional written and verbal communication skills.

• Proficient in Microsoft Office applications including Word, PowerPoint, and Excel.

• Strong attention to detail is essential.

• Ability to work independently and decide on the appropriate course of action.

• A passion for contributing to an organization that is dedicated to continuous improvement of consumer experiences.

• A dedicated workspace that minimizes interruptions to safeguard member PHI/HIPAA information.

• Internet connection with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• Flexibility to start each workday between 6AM and 9AM EST.

• Occasional travel to Humana offices for training or meetings may be necessary.

🏝️ Benefits

• Bonus incentive plan based on both company and/or individual performance.

• Medical, dental, and vision benefits provided.

• 401(k) retirement savings plan available.

• Paid time off is offered.

• Company and personal holidays included.

• Paid parental and caregiver leave provided.

• Short-term and long-term disability coverage available.

• Life insurance is included.

• Internet expense reimbursement for employees working from home in California, Illinois, Montana, or South Dakota.

• Telephone equipment provided as per business requirements.

• Opportunity for remote work from home.

• Flexible scheduling for HireVue interview sessions.