Certified Inpatient Medical Coding Auditor
Little Rock, Pulaski County, Arkansas, 72208, USA
Listed on 2026-08-02
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Healthcare
Medical Billing and Coding, Healthcare Administration, Medical Records, Health Informatics
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Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments.
The Certified Inpatient 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following:
Review inpatient medical records and claims to ensure accurate coding and reimbursement
Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes
Audit coding quality and identify opportunities for improvement
Investigate and resolve provider disputes with a fair, fact-based approach
Analyze complex clinical documentation and coding scenarios
Collaborate with other teams to clarify coding and medical information
Contribute to cost savings by improving payment accuracy and reducing errors
"4+ years of MSDRG coding auditing experience
RHIA, RHIT or CCS Certification (must have held certification for at least 4 years)
Experience performing inpatient coding audits in a health insurance or hospital setting
Experience reading and interpreting claims
Proficiency in gathering or referencing data within different systems simultaneously
Experience in APDRG coding/auditing
Experience in Financial Recovery
Experience in a metric driven operational setting
Use your skills to make an impact
Required Qualifications
Preferred Qualifications
Additional Information
WORK HOURS are Monday-Friday, 8 hours per day, 40 hours per week, and are scheduled between 6AM-6PM. Potential shift to be discussed during the interview.
Work at Home Requirements:
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Final date to receive applications: 07-31-2026
About us
About Humana:
Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our Center Well healthcare services, we make it easier for the millions…
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