Code Edit Disputes Medical Coder

Humana

5d • $48,300 - $65,900 • Remote

About The Position

The Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. The Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience and depth of knowledge of administrative processes and organizational knowledge.

Requirements

• Coding Certification required: AAPC CPC (no Apprentice)
• Minimum of 3 years' experience as a Certified Medical Coder
• Demonstrate ability to problem-solve complex coding issues
• Experience with Medicare and Medicaid coding guidelines
• Strong data entry and attention to detail skills with the ability to manage multiple tasks in a fast-paced setting with competing priorities
• Intermediate experience with Microsoft Word and Excel, Outlook, and Teams

Nice To Haves

• Bachelor's Degree
• 5 or more years of experience as a Certified Medical Coder
• CPMA certification
• MS-DRG auditing or APR auditing experience
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Experience in a production driven environment

Responsibilities

• Reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery.
• Performs advanced administrative, operational, and customer support duties that require independent initiative and judgment.
• Extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records.
• Analyzes, enters and manipulates database.
• Responds to or clarifies internal requests for medical information.
• Makes decisions that typically focus on methods, tactics and processes for completing administrative tasks/projects.
• Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques.
• Works under limited guidance due to previous experience and depth of knowledge of administrative processes and organizational knowledge.

Benefits

• excellent professional development
• continued education
• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree