Senior Inpatient Medical Coding Auditor Professional

Position Overview

• Location Type: Remote/work at home (occasional travel to Humana's offices may be required)
• Job Type: Full time
• Salary: Not specified

This role involves extracting clinical information from medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, PCS) to patient records. The Senior Inpatient Medical Coding Professional handles assignments involving moderately complex to complex issues, requiring in-depth evaluation of variable factors.

Responsibilities

• Confirms appropriate diagnosis related group (DRG) assignments.
• Analyzes, enters, and manipulates databases.
• Responds to or clarifies internal requests for medical information.
• Reviews staff monthly QA review variances.
• Monitors daily inventory and assigns escalated inventory.
• Conducts research on guidelines (CMS, AMA, etc.).
• Trains new coders/auditors.
• Responsible for updating and maintaining processes/resources/guidelines in OneNote & Mentor.
• Serves as a point of contact for coders/auditors.
• Assists coders with coding or technical issues.
• Engages with the team.
• Assists with assignments as appropriate per leader direction.

Requirements

• Experience with all of the following: Inpatient medical coding, analytics, health record security and privacy, HIPAA compliance, and data governance.
• Hold at least one of the following AHIMA Coding Certifications: RHIT, RHIA, or CCS.
• Comprehensive knowledge of MS Word, Excel, and PowerPoint.
• Passion for contributing to an organization focused on continuously improving consumer experiences.
• Experience implementing timely resolution to complex issues.

Preferred Qualifications

• Associate or Bachelor’s degree.
• Previous leadership experience.

Work Style & Hours

• Work Style: Remote/work at home. Occasional travel to Humana's offices for training or meetings may be required.
• Work Hours: Monday-Friday, 8 hours/day, 5 days/week. Start time typically between 7 AM - 8 AM EST. Overtime may be offered but is not mandatory.

Work at Home Requirements

• Recommended download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable, or DSL connection suggested.
• Satellite, cellular, and microwave connections may be used only if approved by leadership.
• Associates living and working from home in California, Illinois, Montana, or South Dakota will receive bi-weekly internet expense payments.
• Humana will provide telephone equipment appropriate for business requirements for Home or Hybrid Home/Office associates.
• Work must be performed from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format

• The hiring process utilizes Hire Vue (formerly Modern Hire) for interviewing.
• Selected candidates may receive an invitation for a pre-recorded Voice Interview and/or an SMS Text Messaging interview via phone or text.
• Pre-recorded interviews are expected to take approximately 10-15 minutes.