Medical Coding Auditor

Humana

2d • Remote

About The Position

The SIU clinical review team is looking for a Medical Coding Auditor. This position includes review of information provided in medical records and requires an understanding of what each line of business allows and restricts as appropriate. The coder will be required to have an in- depth knowledge of Evaluation & Management (E&M) codes. This will include knowledge of coding definitions and how they should be represented in the records. The ideal candidate will be an avid learner with excellent research skills. In addition, this person will be able to communicate audit findings confidently to other medical and lay professionals both internal and external to Humana professionals. The Medical Coding Auditor in this situation must analyze information given, research to gain additional knowledge, and work the review in the proper systems as necessary. 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, in often in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Requirements

• CPC Certification
• Acute outpatient coding experience
• Evaluation & Management billing or coding experience
• Excellent research skills
• Must be passionate about contributing to an organization focused on improving consumer experiences
• 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
• Satellite, cellular and microwave connection can be used only if approved by leadership

Nice To Haves

• Bachelor's degree
• Additional Evaluation & Management coding certification
• Behavioral health office experience

Responsibilities

• Review of information provided in medical records.
• Analyze information given.
• Research to gain additional knowledge.
• Work the review in the proper systems as necessary.
• Respond to or clarify internal requests for medical information.
• Communicate audit findings confidently to other medical and lay professionals both internal and external to Humana professionals.

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
• bi-weekly payment for their internet expense (for associates in California, Illinois, Montana, or South Dakota)
• telephone equipment appropriate to meet the business requirements for their position/job

What This Job Offers

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