Medical Coding Auditor - Remote Eligible

Medical Coding Auditor

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.

The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates database. 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 to ensure correct coding guidelines followed

Utilize encoders and various coding resources

Conduct peer reviews to ensure compliance with coding guidelines and provide reports as needed

Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release of information

Maintain current working knowledge of ICD-10 and CPT coding principles, government regulation, protocols

Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Associates are expected to start each workday between 6AM-9AM EST.

Must reside in Puerto Rico

Bilingual (English/Spanish)

3 years of Outpatient coding and Outpatient auditing experience required within the last 5 years. Experience needs to include CPT surgical coding and auditing.

Certified Medical Coder with at least one of the following credentials: RHIA, RHIT, CCS or CPC through either AHIMA or AAPC

Demonstrated ability to lead process/project initiatives

Travel 10% or less of the work year for training, team meetings, possible onsite audits opportunities and implementation needs.

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. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue to enhance our hiring and decision-making ability. Hire Vue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours 40

Pay Range $44,500 - $60,700 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Humana, Inc. and its affiliated subsidiaries offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and 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 and many other opportunities.

Humana Inc. is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer. It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.