Humana Hiring for Medical Coding Auditor-Remote/Virtual in US at Atlanta, Georgia Full Time

Description

The 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 Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

Where you Come In

The Outpatient Coding Auditor specific to Ambulatory Payment Classification (APC) and Hospital Outpatient facility coding understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.

As a Medical Coding Auditor for Hospital Outpatient/APC Coding Team you will:

• Verify and ensure the accuracy, completeness, specificity and appropriateness of procedure codes based on services rendered

• Review medical documentation for clinical indicators to ensure specific procedures meet clinical criteria and correct coding guidelines specific to Ambulatory Payment Classification (APC) and Hospital Outpatient Facility coding

• Utilize encoders and various coding resource

• Perform CPT/HCPCS 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-9, ICD-10 and CPT coding principles, government regulation and protocols

• Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.

• Support and participate in process and quality improvement initiatives.

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.

Required Qualifications

• Certified Medical Coder with at least one of the following credentials: CPC, COC, CCS, ROCC, CPMA, RHIA, RHIT

• Strong knowledge of CPT/HCPS coding

• Minimum of 3 years prior coding experience

• Outpatient facility auditing experience

• Chemotherapy Infusion experience

• Proven proficiency across a wide range of services, which include outpatient specialty surgeries, anesthesia, cardiology, radiology, interventional radiology and ED

• Experience reading & coding from operative reports

• Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information

• Ability to work independently and manage work load

• Comfortable working in a production based work environment

• For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

• If progressed to offer, you will be required to:

• Provide proof of full vaccination OR

• Commit to weekly testing, following all CDC protocols, OR

• Provide documentation for a medical or religious exemption consideration.

• This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.

Preferred Qualifications

• Ambulatory Payment Classification (APC) coding experience

• Radiation Oncology coding experience

• Knowledge of Microsoft Access

• Experience in prospective payment methodologies

• Strong knowledge of ICD-10 coding

• 3M Coder/Select Coder/ True Code software experience

Additional Information – How we Value You

• Benefits starting day 1 of employment

• Competitive 401k match

• Generous Paid Time Off accrual

• Tuition Reimbursement

• Parent Leave

• Go365 perks for well-being

• Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work.

• Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10M x 1M

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

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.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.

#ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40