Medical Coding DRG Quality Auditor

Become a part of our caring community and help us put health first
 In this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus on DRG audits. You will also drive process improvement initiatives and develop educational materials. This is a full-time, remote/work-from-home position.

Description 

The Inpatient Medical Coding Auditor extracts clinical information from medical records and assigns appropriate codes (e.g., ICD-10-CM, CPT). This role involves analyzing moderately to highly complex issues requiring in-depth evaluation of variable factors. 

          

Where you Come In  

The Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG) 

 

So, do you love working on several different projects? Do you take pride in helping others and being flexible? Do you pay great attention to detail and have a passion for healthcare? Do you have a solid background in medical auditing, coding, and medical record review? If you answered YES to one or more of the above, you should strongly consider this role. 

What Humana Offers 
We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education.  
 

Use your skills to make an impact
 

WORK STYLE: 100% remote/work at home

WORK HOURS: Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Some flexibility might be possible, depending on business needs

Responsibilities 

In this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus on DRG audits. You will also drive process improvement initiatives and develop educational materials. This is a full-time, remote/work-from-home position. 

 

Required Qualifications 

• 7+ years of DRG Coding 

• 5 years of Quality Auditing 

• Medical coding certification from AAPC OR AHIMA (CPC, CCS, CIC, CPMA or equivalent). 

• Prior experience reading and coding from medical records. 

• Strong critical thinking skills. 

• Proficient in independently managing diverse priorities, adept at swiftly transitioning between tasks based on urgency and demand with …