Inpatient Medical Coding Auditor

Humana

2d•Remote

About The Position

Become a part of our caring community and help us put health first 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. Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG) 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. Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices 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: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities Use your skills to make an impact

Requirements

RHIA, RHIT or CCS Certification (have held at least one of these qualifications for 4 years)
MS-DRG coding/auditing experience
3+ years' experience performing inpatient coding reviews/ audits in health insurance and/or hospital settings
Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
Can work independently and determine appropriate course of action
Excellent communication skills both written and verbal
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: 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. Satellite, cellular and microwave connection can be used only if approved by leadership.
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.
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

Nice To Haves

Associate's Degree or higher in Health Information Management (HIM)
Experience in APR DRG coding/auditing
Experience in Financial Recovery
Experience in a fast paced, metric driven operational setting

Responsibilities

Reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the coding disputes team from a variety of medical records.
Consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality.
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.
Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices
Manages multiple priorities, collaborates with peers and ensures timely completion of inpatient coding disputes