Medical Coding Auditor
Remote / Online - Candidates ideally in
Illinois, USA
Listed on 2026-01-16
Illinois, USA
Listing for:
Humana Inc
Full Time, Remote/Work from Home
position Listed on 2026-01-16
Job specializations:
-
Healthcare
Medical Billing and Coding, Healthcare Administration, Medical Records
Job Description & How to Apply Below
Remote Nationwide time type:
Full time posted on:
Posted Todayjob requisition :
R-397778#
** Become a part of our caring community and help us put health first
** 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 procedures 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; minimal travel may be required for onsite meetings.
*
* WORK HOURS:
** Associates will work on EST, regardless of where the associate resides. Work hours can vary, slightly, but all associates start between 6AM-9AM EST. Some flexibility is available, depending on business needs.
** Required Qualifications
*** Minimum of 3+ years post certification experience Outpatient Specialty Surgeries and Procedures for Physicians
* RHIA, RHIT, CCS, CPC, or COC Certification
* Must be passionate about contributing to an organization focused on continuously improving consumer experiences
** Preferred Qualifications**
* ** STRONGLY PREFERRED**:
Experience with coding/auditing multispecialty surgical procedures.
* Experience with coding/auditing Professional Inpatient Claims
* Experience in Select Coder, 3M
* 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…
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