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Humana

Certified Inpatient Medical Coding Auditor

The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of ... Associate benefits are designed to encourage personal wellness and smart healthcare decisions for ...

Humana

Certified Inpatient Medical Coding Auditor

The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of ... Associate benefits are designed to encourage personal wellness and smart healthcare decisions for ...

Humana

Certified Inpatient Medical Coding Auditor

The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of ... Associate benefits are designed to encourage personal wellness and smart healthcare decisions for ...

Native

... with auditors and revised your code based on their feedback. * You should be highly skilled in ... At least 4 years of experience in smart contract development, strong knowledge of blockchain ...

SmarterDx

Clinical Coding Specialist

$75K - $105K/yr

Prior experience in auditing or coding quality assurance roles * Familiarity with evaluation ... Incredible Teammates! - Work alongside smart, supportive, and mission-driven colleagues.

1872 Consulting

Senior Smart Contract Engineer

$107K - $146K/yr

The Senior Smart Contract Engineer will be responsible for implementing and launching their ... auditors and external contributors to document and upgrade currency code. • Support and maintain ...

Plume

Smart Contract Engineer

Prepare code for auditors and iterate on preliminary audit reports * Brainstorm novel dApps to build for Plume mainnet and propose how they should work * Mentor and give guidance to junior smart ...

Etherfi

Smart Contract Lead

New York, NY · On-site

$240K - $300K/yr

Conduct thorough testing and auditing of smart contracts to ensure security and functionality ... Participate in code reviews and provide constructive feedback to peers to maintain high-quality ...

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Certified Inpatient Medical Coding Auditor

Remote

Humana
Health Care and Social Assistance • 10K+ employees
Learn more about Humanaexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 days ago

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 267 frontline employees who took The Breakroom Quiz

Job description

Become a part of our caring community
Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments.

The Certified Inpatient 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following:

  • Review inpatient medical records and claims to ensure accurate coding and reimbursement
  • Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes
  • Audit coding quality and identify opportunities for improvement
  • Investigate and resolve provider disputes with a fair, fact-based approach
  • Analyze complex clinical documentation and coding scenarios
  • Collaborate with other teams to clarify coding and medical information
  • Contribute to cost savings by improving payment accuracy and reducing errors

Use your skills to make an impact

Required Qualifications

  • 4+ years of MSDRG coding auditing experience
  • RHIA, RHIT or CCS Certification (must have held certification for at least 4 years)
  • Experience performing inpatient coding audits in a health insurance or hospital setting
  • Experience reading and interpreting claims
  • Proficiency in gathering or referencing data within different systems simultaneously

Preferred Qualifications

  • Experience in APDRG coding/auditing
  • Experience in Financial Recovery
  • Experience in a metric driven operational setting

Additional Information

WORK HOURS are Monday-Friday, 8 hours per day, 40 hours per week, and are scheduled between 6AM-6PM. Potential shift to be discussed during the interview.

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: 09-04-2026
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 atHumana.comand atCenterWell.com.


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.

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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

Social media

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