Inpatient Coding Auditor - Remote, High-Impact Reimbursement

Humana Inc; Northern (KY); Hybrid; USD 71,000 - 98,000; Full time

Job summary

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM, ICD-10-PCS and DRG codes, and ensure accurate reimbursement.

You will audit coding quality, resolve provider disputes, and collaborate across teams to improve payment accuracy while supporting cost reduction. Remote work with occasional travel to Humana offices; hours are standard 40 per week.

Qualifications

• 4+ years of MSDRG coding auditing experience.
• RHIA, RHIT or CCS certification (held for at least 4 years).
• Experience auditing inpatient coding in health insurance or hospital settings.
• Experience reading and interpreting claims.
• Proficiency in gathering data across multiple systems.

Responsibilities

• 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.
• Use your skills to make an impact.

Skills

MSDRG coding auditing

Inpatient coding

Data gathering across systems

Education

RHIA/RHIT or CCS Certification

Job description

Humana Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM, ICD-10-PCS and DRG codes, and ensure accurate reimbursement.

You will audit coding quality, resolve provider disputes, and collaborate across teams to improve payment accuracy while supporting cost reduction. Remote work with occasional travel to Humana offices; hours are standard 40 per week.