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Remote Humana Medical Coding Jobs in Kentucky (NOW HIRING)

PharMerica

Medicare D Billing Representative

Louisville, KY · On-site +1

$15.75 - $20.25/hr

... Medical Billing experience Remote: May reside anywhere with the Continental USA. No matter what ... Conducts job responsibilities in accordance with the standards set out in the Company's code of ...

Valeris

Executive Case Manager (Remote)

Pikeville, KY · Remote

This role requires a strong understanding of pharmacy and medical billing and coding, excellent ... Remote work eligibility is subject to all work from home criteria met and based on business need ...

BrightSpring

Medicare D Billing Representative

Louisville, KY · Remote

$15.75 - $20.25/hr

... Medical Billing experience Remote: May reside anywhere with the Continental USA. No matter what ... Conducts job responsibilities in accordance with the standards set out in the Company's code of ...

Quora

$166K - $191K/yr

Own the entire software development process from timeline estimation to coding, testing and release ... Quora offers a wide range of benefits including medical/dental/vision coverage, equity refreshers ...

Quora

$166K - $191K/yr

Own the entire software development process from timeline estimation to coding, testing and release ... Quora offers a wide range of benefits including medical/dental/vision coverage, equity refreshers ...

Quora

$166K - $191K/yr

Own the entire software development process from timeline estimation to coding, testing and release ... Quora offers a wide range of benefits including medical/dental/vision coverage, equity refreshers ...

Quora

$166K - $191K/yr

Own the entire software development process from timeline estimation to coding, testing and release ... Quora offers a wide range of benefits including medical/dental/vision coverage, equity refreshers ...

Quora

$166K - $191K/yr

Own the entire software development process from timeline estimation to coding, testing and release ... Quora offers a wide range of benefits including medical/dental/vision coverage, equity refreshers ...

Quora

$166K - $191K/yr

Own the entire software development process from timeline estimation to coding, testing and release ... Quora offers a wide range of benefits including medical/dental/vision coverage, equity refreshers ...

Storage Solutions Inc

Lead Software Developer

Erlanger, KY · On-site +1

$114K - $143K/yr

Erlanger, KY, Atlanta, GA or Westfield, IN, Remote (Eastern or Central Time Zone) The Lead Software ... Lead code reviews, enforce coding standards, and guide system design decisions. * Escalate and ...

Storage Solutions Inc

Lead Software Developer

Erlanger, KY · On-site +1

$114K - $143K/yr

Erlanger, KY, Atlanta, GA or Westfield, IN, Remote (Eastern or Central Time Zone) The Lead Software ... Lead code reviews, enforce coding standards, and guide system design decisions. * Escalate and ...

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All JobsHumana Medical Coding JobsRemote Humana Medical Coding JobsRemote Humana Medical Coding Jobs in Kentucky

Remote Humana Medical Coding information

What is the difference between Remote Humana Medical Coding vs Remote AAPC Medical Coding?

AspectRemote Humana Medical CodingRemote AAPC Medical Coding
CertificationsCPH, CPC, CCSCPC, CCS, CIC
Work EnvironmentRemote, healthcare insurance providerRemote, various healthcare settings
Employer & IndustryHumana, health insurance industryHospitals, clinics, insurance companies

Remote Humana Medical Coding and Remote AAPC Medical Coding both require certifications like CPC and CCS. While both roles are remote and involve medical coding, Remote Humana Medical Coders typically work directly for Humana within the health insurance industry, focusing on insurance claims and policy coding. In contrast, Remote AAPC Medical Coders may work across various healthcare providers and settings, including hospitals and clinics. Both roles demand strong coding skills and certification but differ mainly in employer and specific industry focus.

Is it easy to get a remote job as a medical coder?

Securing a remote medical coding job can be competitive, but having relevant certifications such as CPC and experience with coding software improves chances. Many employers value accuracy, attention to detail, and familiarity with medical records, making these important factors in the hiring process.

Will AI eventually replace medical coders?

Remote Humana Medical Coders perform detailed coding tasks that require understanding medical terminology and documentation, which AI tools can assist but not fully replace. AI is expected to augment coding processes by increasing efficiency and accuracy, but human oversight remains essential for complex cases and quality assurance. Coding professionals will need to adapt by developing skills in managing and validating AI-generated data.

Is it hard to get hired at Humana?

Getting hired as a remote medical coder at Humana can be competitive, as the company often seeks candidates with relevant certifications like CPC or CCS and prior coding experience. Strong attention to detail, knowledge of coding guidelines, and familiarity with coding software can improve your chances of being hired.

Is Humana a good company to work for remotely?

Remote medical coding positions at Humana are generally considered stable with flexible schedules and opportunities for professional growth. Employees often cite supportive management and a focus on work-life balance, though experiences can vary based on individual roles and departments.
Remote Humana Medical Coding jobs near you
Medicare D Billing Representative

Medicare D Billing Representative

PharMerica

Louisville, KY • On-site, Remote

$15.75 - $20.25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 5 days ago

PharMerica rating

6.6

Company rating: 6.6 out of 10

Based on 103 frontline employees who took The Breakroom Quiz

64th of 109 rated pharmacies

Job description

Our Company
PharMerica
Overview
PharMerica, a part of Brightspring Health Services, is a long-term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States.
The Medicare D Biller serves as a primary liaison for the Clinical Hub, maintaining proactive communication with pharmacists, healthcare facilities, physicians, and Prescription Drug Plans (PDPs) regarding therapeutic interchange opportunities and prior authorization requests. This role is responsible for researching payment denials by contacting insurance plans to determine the cause of denials and coordinating with facilities to obtain supporting information. Additionally, the Medicare D Biller updates and documents prior authorizations, including clinical justifications, while ensuring the accurate and timely completion of all required authorization forms.
The position requires a high level of attention to detail when initiating, processing, and tracking prior authorizations on behalf of customers. Working closely with EMAR systems, healthcare facilities, and clinical teams, the Medicare D Biller serves as a key point of contact throughout the prior authorization process, ensuring efficient coordination, thorough documentation, and successful resolution of authorization requests.
The ideal candiate will be a Certified Pharmacy Technician or Medical Assistant Certification (desired) and have Third party Medical Billing experience
Remote: May reside anywhere with the Continental USA.
No matter what time zone in which you reside, you must be able to work Central Time Zone hours
Schedule: Monday - Friday 11am - 7:30pm CENTRAL Time Zone
Benefits and perks for You!
  • Medical, Dental, Vision insurance
  • Health Savings & Flexible Spending Accounts (up to $5,000 for childcare)
  • Tuition discounts & reimbursement
  • 401(k)
  • Company Paid Time Off*
  • Shift Differential
  • DailyPay
  • Pet Insurance
  • Employee wellness and discount programs

Responsibilities
  • Act as a resource to the facilities in obtaining information completing necessary documentation or following up on outstanding claims
  • Individual with an understanding of Insurance and Medicaid formularies and processes including the prior authorization processes
  • Makes outgoing calls to Facilities, Plans, and Physician's offices as needed to obtain approvals
  • Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to effectively communicate and resolve customer issues
  • Performs other tasks as assigned
  • Achieves productivity goals with regard to calls/claims per hour as determined by the Director and Clinical Hub Manager
  • Provide clinical support to members of the RxAllow team regarding prior authorization concerns / submissions
  • Conducts job responsibilities in accordance with the standards set out in the Company's code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and State Laws, and applicable professional standards
  • Familiar with the claim adjudication process
  • Develop a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow

Qualifications
  • High School Diploma, Associates degree; Bachelor's degree preferred
  • Certified Pharmacy Technician or Medical Assistant Certification desired
  • Third party Medical Billing experience
  • EMAR system knowledge
  • One to three years of pharmacy experience preferred
  • Three years of call center experience preferred
  • Understanding of insurance and medicaid formularies and processes including the prior authorization processes
  • Familiar with the claim adjudication process
  • Proficiency in Microsoft Office programs
  • Prioritize work to meet daily and competing deadlines

About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.

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