Talent.com
Inpatient Medical Coding Auditor
Inpatient Medical Coding AuditorHumana • Boston, MA, United States
Inpatient Medical Coding Auditor

Inpatient Medical Coding Auditor

Humana • Boston, MA, United States
1 day ago
Job type
  • Full-time
Job description

Become a part of our caring community and help us put health first

The 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG).

The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. 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. Follows established guidelines / procedures.

Use your skills to make an impact

  • Additional Job Description WORK STYLE : Remote / work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS : Typical business hours are Monday-Friday, 8 hours / day, 5 days / week, scheduled between 6AM-6PM. Some flexibility might be possible, depending on business needs.

Required Qualifications | What it takes to Succeed

  • RHIA, RHIT or CCS Certification (should have held at least one of these qualifications for 4 years)
  • MS-DRG coding / auditing experience
  • Experience reading and interpreting claims
  • Experience in performing inpatient coding reviews / audits in health insurance and / or hospital settings
  • Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
  • Strong attention to detail
  • Can work independently and determine appropriate course of action
  • Ability to handle multiple priorities
  • Capacity to maintain confidentiality
  • Excellent communication skills both written and verbal
  • Preferred Qualifications

  • Experience in APR DRG coding / auditing
  • Experience in Financial Recovery
  • Experience in a fast paced, metric driven operational setting
  • 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 forward to next round of interviews.

    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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

    Application Deadline : 12-25-2040

    About us

    Humana Inc. (NYSE : HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

    Equal Opportunity Employer

    It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

    Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our

    Create a job alert for this search

    Inpatient Medical Coding Auditor • Boston, MA, United States

    Similar jobs
    Inpatient Medical Coder - FT - Up to $5,000 Sign on Bonus

    Inpatient Medical Coder - FT - Up to $5,000 Sign on Bonus

    Datavant • Boston, MA, United States
    Full-time
    Datavant is a data platform company and the world's leader in health data exchange.Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format....Show more
    Last updated: 1 day ago • Promoted
    Ambulatory Coding Auditor / Educator

    Ambulatory Coding Auditor / Educator

    Brockton Hospital • West Bridgewater, MA, United States
    Full-time
    Signature Healthcare is Southeastern Massachusetts’ premier local provider of quality, personalized medical services.We are comprised of the award-winning not-for-profit Signature Healthcare Brockt...Show more
    Last updated: 1 day ago • Promoted
    Physician (MD / DO) - Internal Medicine - General / Other in Brockton, MA

    Physician (MD / DO) - Internal Medicine - General / Other in Brockton, MA

    LocumJobsOnline • Brockton, MA, US
    Full-time
    Doctor of Medicine | Internal Medicine - General / Other.Competitive weekly pay (inquire for details) .LocumJobsOnline is working with The Inline Group to find a qualified Internal Medicine MD in Bro...Show more
    Last updated: 30+ days ago • Promoted
    Infectious Disease Physician

    Infectious Disease Physician

    Curare Group, Inc. • BROCKTON, Massachusetts, US
    Full-time
    Infectious Disease physician employment in Massachusetts : Infectious Disease opportunity at a major community hospital in Brockton, Massachusetts, offering a balanced inpatient and outpatient prac...Show more
    Last updated: 26 days ago • Promoted
    Lead Inpatient Medical Coder

    Lead Inpatient Medical Coder

    Oracle • Boston, MA, United States
    Full-time
    Join our innovative healthcare information management team as a Lead Inpatient Medical Coder.This pivotal position is essential in connecting clinical data with technology, driving the development ...Show more
    Last updated: 5 days ago • Promoted
    Ambulatory Coding Auditor / Educator

    Ambulatory Coding Auditor / Educator

    Signature HealthCARE • West Bridgewater, MA, United States
    Full-time
    Signature Healthcare is Southeastern Massachusetts' premier local provider of quality, personalized medical services.We are comprised of the award-winning not-for-profit Signature Healthcare Brockt...Show more
    Last updated: 8 days ago • Promoted
    Outpatient Coding Specialist

    Outpatient Coding Specialist

    Signature Healthcare • West Bridgewater, Massachusetts, United States, 02379
    Full-time
    Signature Healthcare is Southeastern Massachusetts’ premier local provider of quality, personalized medical services.We are comprised of the award-winning not-for-profit Signature Healthcare Brockt...Show more
    Last updated: 11 days ago
    HIMS Coder

    HIMS Coder

    Encompass Health • Braintree, MA, United States
    Part-time
    Medical HIMS Coder Full-Time career opportunity .Valued for your Expertise in HIMS Coding.Are you a skilled Health Information Management Systems (HIMS) Coder seeking a career that aligns with your...Show more
    Last updated: 1 day ago • Promoted
    ObGyn Physician

    ObGyn Physician

    CompHealth • Brockton, Massachusetts, US
    Full-time
    ObGyn physician job in Massachusetts : Interested in this assignment? Or maybe you still have not found what you are looking for? Contact one of our specialty-specific recruiters to get access to o...Show more
    Last updated: 19 hours ago • Promoted • New!
    Breast Imaging Radiologist

    Breast Imaging Radiologist

    AMN Healthcare • Brockton, US
    Full-time
    Job Description & Requirements.StartDate : ASAP Pay Rate : $520000.Breast Imaging Radiologist – Suburban Boston | No Call | Competitive Compensation + Work-Life Balance.K–$575K | 2 Re...Show more
    Last updated: 30+ days ago • Promoted
    Internal Medicine Physician

    Internal Medicine Physician

    RecruitWell • Brockton, Massachusetts, US
    Full-time +2
    Internal Medicine physician employment in Massachusetts : Brockton, Massachusetts Primary Care Physician Job.Miles South of Boston | Permanent Position. Do you know someone who may be a good fit?.B...Show more
    Last updated: 30+ days ago • Promoted
    Certified Outpatient Medical Coder

    Certified Outpatient Medical Coder

    VirtualVocations • Dorchester, Massachusetts, United States
    Full-time
    A company is looking for a Certified Outpatient Medical Coder, Professional Billing.Key Responsibilities Reviews medical records to assign appropriate diagnostic and procedural codes Assigns cha...Show more
    Last updated: 1 day ago • Promoted
    Travel MRI Tech - $3240 / Week

    Travel MRI Tech - $3240 / Week

    Lancesoft • Brockton, MA, US
    Full-time
    Lancesoft is seeking an experienced MRI Tech for an exciting Travel Allied job in Brockton, MA.Shift : 4x10 hr days Start Date : ASAP Duration : 13 weeks Pay : $3240 / Week. Saturday : 7 : 00 AM → 11 : 00 PM...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Telemetry - $1,984 to $2,137 per week in Salem, MA

    Travel Nurse RN - Telemetry - $1,984 to $2,137 per week in Salem, MA

    TravelNurseSource • Salem, MA, US
    Full-time
    Registered Nurse (RN) | Telemetry.TravelNurseSource is working with Host Healthcare to find a qualified Telemetry RN in Salem, Massachusetts, 01970!. Host Healthcare is an award-winning travel healt...Show more
    Last updated: 3 days ago • Promoted
    Professional Surgical Coder

    Professional Surgical Coder

    South Shore Health • Boston, Massachusetts, us
    Full-time
    Job Description Summary Under experienced leadership the Professional Surgical Coder is an advanced coding position that is responsible for accurate and timely assignment of codes to diagnoses and ...Show more
    Last updated: 3 hours ago • Promoted • New!
    Travel Nurse - Endoscopy Job in Brockton, MA - $14,612 per Month (2 Years Experience Needed)

    Travel Nurse - Endoscopy Job in Brockton, MA - $14,612 per Month (2 Years Experience Needed)

    Vetted Health • Brockton, MA, US
    Full-time
    Vetted is seeking a RN - Endoscopy for a travel job in Brockton, Massachusetts.Must have 2 years of experience.This contract pays approximately $14,612 / month gross. Assignment details : Contract leng...Show more
    Last updated: 4 days ago • Promoted
    Full Time & Part Time Urgent Care Physician, South of Boston

    Full Time & Part Time Urgent Care Physician, South of Boston

    HealthEcareers - Client • South Weymouth, MA, USA
    Full-time +1
    Mass General Brigham is seeking both Full Time & Part Time.Board Certified / Board-Eligible Emergency Medicine, Family Medicine, or Med-Peds physicians. Urgent Care Centers in South Weymouth and Pem...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse - RN - MS / TELE - Medical Surgical / Telemetry - $1897.2 / Week - Hiring Now

    Travel Nurse - RN - MS / TELE - Medical Surgical / Telemetry - $1897.2 / Week - Hiring Now

    CrossMed Healthcare • Salem, MA, US
    Full-time
    CrossMed Healthcare is seeking an experienced Medical Surgical / Telemetry Registered Nurse for an exciting Travel Nursing job in Salem, MA. Shift : 12 hr nights Start Date : 02 / 15 / 2026 Duration : 13 wee...Show more
    Last updated: 1 day ago • Promoted