Inpatient Medical Coding Auditor

** Become a part of our caring community*
* The Inpatient Medical Coding Auditor - MSDRG appeals reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the appeals team from a variety of medical records.

The Disputes Auditor - MSDRG Inpatient Coding consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality.

+ Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG)

+ Ensures overall accuracy and compliance of coding appeal reviews by adhering to all appropriate coding guidelines and communicates appeals outcomes to providers in a professional and concise manner.

+ Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices

+ Manages multiple priorities, collaborates with peers and ensures timely completion of inpatient coding appeals

** Use your skills to make an impact*
* ** WORK STYLE:
** Remote, work le this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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* WORK HOURS:

** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week-- some flexibility might be possible, once training is complete and depending on business needs.

Associates are expected to start each workday between 6AM-9AM EST, regardless of their home time zone.

** Required Qualifications*
* + RHIA, RHIT, or CCS Certification

+ At least 2 years' experience in acute in-patient coding experience and/or MS-DRG auditing

+ Recent experience auditing using CMS Manual, LCD, NCD, and Coding Guidelines

+ Experience reading and interpreting claims

+ Excellent written and verbal communication skills

+ Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel

+ Strong attention to detail

+ Can work independently and determine appropriate course of action

+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences

** Preferred Qualifications*
* + Associate's Degree or higher in Health Information Management (HIM)

+ Experience in Financial Recovery

+ Experience in a fast paced, metric driven operational setting

+ Experience in APR DRG coding/auditing

** Additional Information*
* ** Work-At-Home Requirements*
* + To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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.

+ Satellite, cellular and microwave connection can be used only if approved by leadership.

+ Employees 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

** Our Hiring Process*
* As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue to enhance our hiring and decision-making ability. Hire Vue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected, you will receive correspondence inviting you to participate in a Hire Vue assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 10-15 minutes. Your answers will be reviewed, and you will subsequently be informed if you will be moving forward to next round.

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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…