Medical Coding Auditor

Humana

Olympia, WA(remote)

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JOB DETAILS

SALARY

$53,100–$72,500 Per Year

SKILLS

Affirmative Action, Analysis Skills, Auditing, Cellular Telephone, Certified Coding Specialist (CCS), Clinical Study Publications, Code Reviews, Content Management Systems (CMS), Current Procedural Terminology (CPT), DSL (Digital Subscriber Line), Detail Oriented, Genetics, Government Regulations, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Hospital, ICD-10, Insurance, LCD (Liquid Crystal Display), Leadership, Medicaid, Medical Coding, Medical Records, Medical Treatment, Medicare, Microwaves, Military, Multitasking, Patient Care, Patient Confidentiality, Procedure Development, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Rehabilitation Act, Request for Information (RFI), Requirements Validation/Verification, Short Messaging Service (SMS), Willing to Travel, Wireless Communications, Work From Home

LOCATION

Olympia, WA

POSTED

2 days ago

**Become a part of our caring community** The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. 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 trauma activations meet clinical criteria and correct coding guidelines + Utilize encoders and various coding resources + Perform CPT Procedure reviews + Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release of information + Maintain current working knowledge of ICD-10 and CPT coding principles, government regulation, protocols **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 work hours are Monday-Friday, 8 hours/day, 5 days/week, between 6AM-6PM EST. Some flexibility might be possible, once training is competed and depending on business need. **Required Qualifications** + RHIA, RHIT, CCS Certification + Minimum of 3+ years post certification experience with acute inpatient coding + Experience reading & coding from trauma activations + Strong knowledge of NCD/LCDs, CMS Manual, NCCI Edits, and coding guidelines + Strong attention to detail, can work independently and determine appropriate course of action, & ability to handle multiple priorities + Comfortable working in a production-based work environment + Ability to work independently and manage workload **Preferred Qualifications** **STRONGLY PREFERRED** : + Experience with coding/auditing Professional Inpatient Claims + Experience with the Claims Life Cycle **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 participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 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. $53,100 - $72,500 per year **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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 05-21-2026 **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. ? **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 the Company

Humana

INDUSTRY

Other/Not Classified

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