Medical Coding Auditor

Become a part of our caring community   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   WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:  Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Once training is completed, associates may start as early as 6AM in their own time zone, depending on business needs.

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 Preferred Qualifications Bachelor's Degree 3 or more years of experience as a certified medical coder Additional Information Work at Home Requirements •            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 Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire 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