Inpatient Medical Coding Auditor

Inpatient Medical Coding Auditor – PPI Coding Disputes

Reports to the manager and reviews DRG, ICD-10-CM, and PCS coding assignments for accuracy within the coding disputes team. The auditor consults and collaborates with coding professionals across departments to ensure timely, compliant, and high-quality coding dispute outcomes.

• Review DRG and ICD-10-CM/PCS coding assignments for accuracy.
• Ensure overall accuracy and compliance of coding dispute reviews by adhering to coding guidelines.
• Communicate dispute outcomes to providers in a professional and concise manner.
• Leverage auditing expertise to make coding decisions based on industry guidelines and best practices.
• Manage multiple priorities and collaborate with peers to ensure timely completion of inpatient coding disputes.

• RHIA, RHIT or CCS certification held for at least four years.
• Minimum of three years performing inpatient coding reviews or audits in health insurance and/or hospital settings.
• MS-DRG coding and auditing experience.
• Working knowledge of Microsoft Office Word, PowerPoint, and Excel.
• Ability to work independently and determine appropriate course of action.
• Excellent written and verbal communication skills.

• Associate's degree or higher in Health Information Management.
• Experience in APR DRG coding or auditing.
• Experience in financial recovery.
• Experience in a fast-paced, metric-driven operational setting.

• Health benefits effective day one.
• 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.

Work from home, remote. Occasional travel to Humana offices for training or meetings may be required. Typical hours are Monday through Friday, eight hours per day, with some flexibility.

Minimum internet download speed of 25 Mbps and upload speed of 10 Mbps. Wireless, wired cable, or DSL connection recommended. Satellite, cellular, or microwave connections allowed only with leadership approval. Employees in California, Illinois, Montana, or South Dakota receive a bi-weekly payment for internet expenses. Telephone equipment provided.

Humana is an equal opportunity employer and does not discriminate against any employee or applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. Arbitrated action applies to all employment actions.