Medical Coding Auditor (Outpatient)

Humana

16h • $59,300 - $80,900 • Remote

About The Position

The Medical Coding Auditor 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. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Requirements

• CPC, COC, CCS, RHIA, or RHIT Certification with a minimum of 3 years post-certification experience
• Minimum of 2 years of outpatient medical record auditing experience including knowledge of outpatient coding conventions and standards
• Strong knowledge of NCD/LCDs, CMS Manual, NCCI Edits, and coding guidelines
• Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information
• Strong attention to detail, can work independently and determine appropriate course of action, & ability to handle multiple priorities
• Comfortable working in a production-based work environment
• Ability to work independently and manage workload
• Strong written and verbal communication skills; strong analytical, organizational and time management skills
• Working knowledge of Microsoft Office Programs (Word, Excel)
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Nice To Haves

• 5+ years prior coding experience
• Minimum of 3 years' experience reading and interpreting claims
• Outpatient facility auditing experience
• 3M Coder software experience
• CRM/SRO, Pareo, MOAT experience
• Prior appeals and/or disputes auditing experience
• Experience in Financial Recovery
• Experience in a fast paced, metric driven operational setting
• Advanced and/or Specialty Coding Certifications

Responsibilities

• Extracts clinical information from a variety of medical records.
• Assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records.
• Interpretations and independent determination of the appropriate courses of action for varied work assignments.

Benefits

• medical
• dental
• vision
• 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
• bi-weekly payment for internet expense (for associates in California, Illinois, Montana, or South Dakota)
• telephone equipment

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed