Inpatient Medical Coding Auditor

Humana; Missouri; Remote; USD 71,000 - 98,000; Full time

Job summary

A leading healthcare provider is seeking an experienced Inpatient Medical Coding Auditor to work remotely. You will review inpatient hospital claims, ensuring proper reimbursement while working in a metrics-driven environment. The ideal candidate will have extensive coding experience, relevant certifications, and strong analytical skills. This position offers competitive compensation and comprehensive benefits package, with potential for bonuses.

Benefits

Competitive benefits including medical, dental, and vision

401(k) retirement savings plan

Life insurance and disability coverage

Bonus incentive plan based on performance

Qualifications

• Must have held at least one certification for 4 years.
• Must have experience in performing inpatient coding reviews.
• Ability to handle multiple priorities.

Responsibilities

• Review inpatient hospital claims for proper reimbursement.
• Contribute to overall cost reduction and correct claims payment.
• Analyze and manipulate databases.

Skills

RHIA, RHIT or CCS Certification

MS-DRG coding/auditing experience

Experience reading and interpreting claims

Strong attention to detail

Excellent communication skills both written and verbal

Tools

Microsoft Office Programs (Word, PowerPoint, Excel)

Job description

Overview

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.

Where you Come In

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

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 Hire Vue to enhance our hiring and decision-making ability. If selected to move forward from your application prescreen, you will be invited to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. The interviews are designed to assess your relevant skills and experience and may take approximately 10-15 minutes for voice or 5-10 minutes for SMS.

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 offers competitive benefits that support whole-person well-being, including medical, dental and vision benefits, 401(k) retirement savings plan, time off, disability coverage, life insurance and other opportunities.

Application Deadline: 10-30-2025

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.

Equal Opportunity Employer

Humana does not discriminate in employment and complies with applicable civil rights laws. We also provide free language interpreter services. See our accessibility resources at Humana’s website for details.