Medical Coding Auditor

Humana

1d • Remote

About The Position

The Medical Coder 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 Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates databases. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure correct coding guidelines are met Perform CPT/HCPCS code reviews for professional Evaluation and Management services: Inpatient, Office, ER, Telehealth, Home Health, Behavioral health and/or minor procedures Maintain productivity metrics Must maintain quality metrics Utilize encoders and various coding resources Maintain current working knowledge of ICD-10 and CPT coding principles, government regulation, protocols Maintain strict patient and physician confidentiality Use your skills to make an impact

Requirements

• CPC, CCS, COC, RHIA, or RHIT Certification either through AAPC or AHIMA
• Minimum of 3 years post-certification experience auditing Professional Evaluation & Management (E&M) Services - Inpatient, Office, ER, Telehealth, Home Health, Behavioral health and/or minor procedures
• Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
• Can work independently and determine appropriate courses of action

Nice To Haves

• Bachelor's Degree
• 3 or more years of experience as a certified medical coder

Responsibilities

• Review medical documentation for clinical indicators to ensure correct coding guidelines are met
• Perform CPT/HCPCS code reviews for professional Evaluation and Management services: Inpatient, Office, ER, Telehealth, Home Health, Behavioral health and/or minor procedures
• Maintain productivity metrics
• Maintain quality metrics
• Utilize encoders and various coding resources
• Maintain current working knowledge of ICD-10 and CPT coding principles, government regulation, protocols
• Maintain strict patient and physician confidentiality
• Analyzes, enters, and manipulates databases
• Responds to or clarifies internal requests for medical information

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, 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