ZipRecruiter

Log In

2

Full Time Humana Medical Coding Jobs in Wisconsin

Upland Hills Health

Medical Coding Team Lead

Dodgeville, WI · Remote

$23.25 - $31.75/hr

Shift: Full-time (1.0 FTE) day shift position, Monday through Friday 8 a.m. to 4:30 p.m. Role Responsibilities: * Supervise, mentor, and support a team of medical coders in daily operations ...

UWHealth

Supervisor - Inpatient Coding

Middleton, WI · On-site +1

$22.25 - $27/hr

This is a full time, 1.0 FTE position. Shifts will be scheduled Monday - Friday between the hours ... Graduate of a Medical Coding Program Required or * Associate's Degree in healthcare related field ...

Humana

Case Manager - Sparta, WI

Sparta, WI

$53.70K - $72.60K/yr

... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ... Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings ...

Humana

Case Manager

Eau Claire, WI

$53.70K - $72.60K/yr

... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ... Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings ...

next page

Showing results 1-20

People also search for

All JobsFull Time Humana Medical Coding JobsFull Time Humana Medical Coding Jobs in Wisconsin

Full Time Humana Medical Coding information

What are the key skills and qualifications needed to thrive as a Full Time Humana Medical Coder, and why are they important?

To thrive as a Full Time Humana Medical Coder, you need a solid understanding of medical terminology, anatomy, and ICD-10/CPT/HCPCS coding systems, typically supported by a coding certification such as CPC, CCS, or CCA. Familiarity with health information management systems, electronic health records (EHRs), and coding software is commonly required. Strong attention to detail, analytical thinking, and effective communication skills help ensure accurate and compliant code assignment. These competencies are vital for maintaining data integrity, optimizing reimbursement, and supporting proper healthcare delivery within regulatory guidelines.

What are some common challenges faced by Full Time Humana Medical Coding professionals, and how can they be managed?

Medical coders at Humana often encounter challenges such as keeping up with frequent updates to coding standards (like ICD-10 and CPT), ensuring accuracy under productivity pressures, and clarifying ambiguous documentation from healthcare providers. To manage these challenges, coders typically participate in ongoing training, utilize Humana’s coding resources, and collaborate closely with clinical staff for clarification. Building strong attention to detail and effective communication skills will help you succeed and reduce the risk of claim denials or errors.

What are Full Time Humana Medical Coders?

Full Time Humana Medical Coders are professionals employed by Humana, a major health insurance company, who review, analyze, and assign standardized medical codes to diagnoses and procedures from patient records. These codes are used for billing, insurance claims, and maintaining accurate medical records. Working full time typically means a 40-hour work week, often with benefits and opportunities for advancement. Coders at Humana must be knowledgeable about ICD-10, CPT, and HCPCS coding systems and adhere to strict privacy and compliance standards.
What are the most commonly searched types of Humana Medical Coding jobs in Wisconsin? The most popular types of Humana Medical Coding jobs in Wisconsin are:
What are popular job titles related to Full Time Humana Medical Coding jobs in Wisconsin? For Full Time Humana Medical Coding jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Full Time Humana Medical Coding jobs in Wisconsin look for? The top searched job categories for Full Time Humana Medical Coding jobs in Wisconsin are:
What cities in Wisconsin are hiring for Full Time Humana Medical Coding jobs? Cities in Wisconsin with the most Full Time Humana Medical Coding job openings:
Full Time Humana Medical Coding jobs near you
Medical Coding & Prior Authorization Specialist

Medical Coding & Prior Authorization Specialist

Crossing Rivers Health

Prairie Du Chien, WI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Job description

Medical Coding & Prior Authorization Specialist Full Time / Days / On-Site 40 hours per week
Come join our team! Crossing Rivers Health provides competitive pay along with an excellent benefits package including medical, dental, vision; life insurance, short term disability, paid time off, a retirement plan w/company match, and more!
Our core values are practiced and exhibited throughout the organization in our actions and in services provided. Joy : Unity : Integrity : Compassion : Excellence
The Medical Coding and Prior Authorization Specialist plays a dual role in supporting accurate clinical documentation and ensuring timely authorization of services for patients at Crossing Rivers Health. This position is responsible for coding all/assigned encounter types; reviewing and correcting coding related denials and managing prior authorization processes for specialty services, surgical procedures, therapies and imaging. The goal of this role is to support compliance, maximize reimbursement and ensure patients have timely access to medically necessary care.
Essential Job Functions
  • Reviews clinical documentation to ensure coding accuracy, completeness, and compliance with regulations.
  • Assigns diagnoses, procedural/treatment, professional billing codes for all patient type encounters (Clinic, Center for Specialty Care, Emergency, Urgent Care, Outpatient Services, Lab, Imaging, Physical/Occupational/Speech Therapy, Surgery, Observation/Inpatient, Obstetrics) utilizing ICD-10-CM, ICD-10-PCS or CPT guidelines
  • Working knowledge of modifier usage, CCI edits, HCPCS, LCD/NCI regulations
  • Data entry/verification/appropriate sequencing into electronic health record
  • Submit provider queries as appropriate following approved guidelines.
  • Identify and resolve clinical documentation and charge capture data discrepancies
  • Initiates and manages prior authorization requests for surgical procedures, specialty services, imaging, and rehabilitation therapies.
  • Verifies medical necessity and payer-specific criteria prior to submission of authorization requests.
  • Assists with denial follow-up and appeals related to coding or prior authorization
  • Collaborates with providers, nursing staff, and scheduling teams to obtain required clinical documentation for approvals.
  • Monitors pending authorizations, ensuring timely follow-up and communication with payers, providers, and patients.
  • Tracks and reports trends in authorization denials and coding discrepancies; participates in denial prevention initiatives.
  • Maintains current knowledge of payer guidelines, coding updates, and regulatory requirements.
  • Supports staff and providers through education on documentation and authorization best practices.
  • Contributes to a culture of accountability, continuous improvement, and patient-centered service.
  • Assist in provider education in use of coding guidelines and practices and proper documentation techniques
  • Assist with coding quality review activities for accuracy and compliance monitoring
  • Commitment to continuous learning as required to stay up-to-date on coding and prior authorization guidelines.
  • Other job duties and responsibilities as assigned to effectively meet the needs of the patients, the department, and the organization as a whole.

Competencies
  • Accountability - Ability to accept responsibility and account for his/her actions.
  • Accuracy - Ability to perform work accurately and thoroughly.
  • Business Acumen - Ability to grasp and understand business concepts and issues.
  • Communication - The ability to get one's ideas across to others through oral or written means and to understand the ideas of others through effective listening skills.
  • Detail Oriented - Ability to pay attention to the minute details of a project or task.
  • Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards.
  • Honesty/ Integrity - Ability to be truthful and be seen as credible in the workplace.
  • Organized - Possessing the trait of being organized or following a systematic method of performing a task.
  • Reliability - The trait of being dependable and trustworthy.
  • Responsible - Ability to be held accountable or answerable for one's conduct.

Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.
Requirements
Education
  • High School Graduate or General Education Degree (GED) : Required
  • Associate's Degree in Health Information Management, Medical Coding, or related field: Required
  • Registered Health Information Technician or related certification within 6 months of hire.

Experience
  • 2+ years of medical coding experience in a Critical Access Hospital or similar setting preferred.
  • Prior authorization and insurance verification experience preferred.

Computer Skills
  • Proficient in Microsoft Office
  • Epic experience preferred

Apply