Become a part of our caring community The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for ...
Become a part of our caring community The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for ...
Certified Professional Medical Auditor (CPMA); AND * National Alliance of Medical Auditing Specialists (NAMAS): Certified Evaluation and Management Auditor (CEMA). * Other medical coding auditing ...
Certified Professional Medical Auditor (CPMA); AND * National Alliance of Medical Auditing Specialists (NAMAS): Certified Evaluation and Management Auditor (CEMA). * Other medical coding auditing ...
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Outpatient Coding Auditor
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Medical Coding Auditor information
See Connecticut salary details
$32.3K - $37.4K
4% of jobs
$37.4K - $42.5K
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$42.5K - $47.5K
5% of jobs
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8% of jobs
$55.5K is the 25th percentile. Wages below this are outliers.
$52.6K - $57.6K
10% of jobs
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4% of jobs
$62.7K - $67.8K
13% of jobs
The median wage is $68.3K / yr.
$67.8K - $72.8K
39% of jobs
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$77.9K - $82.9K
5% of jobs
$82.9K - $88K
3% of jobs
$32.3K
$65.1K
$88K
How much do medical coding auditor jobs pay per year?
What is the difference between Medical Coding Auditor vs Medical Billing Specialist?
| Aspect | Medical Coding Auditor | Medical Billing Specialist |
|---|---|---|
| Certifications | CPMA, CPC, CCS | CPB, CPC, CMA |
| Work Environment | Hospitals, clinics, insurance companies | Medical offices, billing companies |
| Primary Focus | Reviewing coding accuracy and compliance | Processing patient bills and payments |
| Industry Usage | Healthcare providers, insurance | Healthcare providers, billing services |
Medical Coding Auditors focus on reviewing and ensuring the accuracy of medical codes used for billing and reimbursement, often working in compliance and quality assurance roles. Medical Billing Specialists handle the submission of claims, patient billing, and payment processing. While both roles require coding knowledge and certifications, their primary responsibilities and work environments differ, making them distinct but related careers in healthcare revenue cycle management.
What are the key skills and qualifications needed to thrive as a medical coding auditor, and why are they important?
What does a medical coding auditor do?
What are some common challenges faced by medical coding auditors and how can they be addressed?
Do medical coders or medical auditors make more money?

Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 4 days ago
Humana rating
8.0
Based on 265 frontline employees who took The Breakroom Quiz
163rd of 304 rated insurance
Job description
Become a part of our caring community
The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the coding disputes team from a variety of medical records.
The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality.
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Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG)
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Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner.
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Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices
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Manages multiple priorities, collaborates with peers and ensures timely completion of inpatient coding disputes
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:
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Health benefits effective day 1
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Paid time off, holidays, volunteer time and jury duty pay
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Recognition pay
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401(k) retirement savings plan with employer match
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Tuition assistance
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Scholarships for eligible dependents
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Parental and caregiver leave
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Employee charity matching program
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Network Resource Groups (NRGs)
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Career development opportunities
Use your skills to make an impact
WORK STYLE: Work at home, remote. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
WORK HOURS: Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. Some flexibility might be available, depending on business needs.
Required Qualifications
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RHIA, RHIT or CCS Certification (have held at least one of these qualifications for 4 years)
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MS-DRG coding/auditing experience
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3+ years' experience performing inpatient coding reviews/ audits in health insurance and/or hospital settings
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Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
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Can work independently and determine appropriate course of action
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Excellent communication skills both written and verbal
Preferred Qualifications
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Associate's Degree or higher in Health Information Management (HIM)
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Experience in APR DRG coding/auditing
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Experience in Financial Recovery
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Experience in a fast paced, metric driven operational setting
Additional Information
Work-At-Home Requirements
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To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
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At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
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Satellite, cellular and microwave connection can be used only if approved by leadership.
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Employees 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.
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Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
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Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Our Hiring Process
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected, you will receive correspondence inviting you to participate in a HireVue assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 10-15 minutes. Your answers will be reviewed, and you will subsequently be informed if you will be moving forward to next round.
#LI-LM1
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 08-30-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?Humana.com?and at?CenterWell.com.
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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. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
About Humana
Sourced by ZipRecruiter
Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Louisville, KY, US
Year founded
1961