Remote Behavioral Health Coding Auditor - Outpatient

Humana Inc; Nashville (TN); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits from day 1

401(k) retirement savings plan with ER

Tuition assistance

Parental and caregiver leave

Employee charity matching program

Job summary

Humana Inc. is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes in a metrics-driven, remote environment.

This role sits on the PPI Coding Disputes Team and focuses on outpatient BH coding disputes with CPT/HCPCS assignments. You will review disputes, ensure accuracy and timeliness, collaborate with coding professionals across departments, and communicate outcomes to providers in a professional manner.

Qualifications

• CPC or CCS certification required.
• 1+ years reading Behavioral Health claims.
• 3+ years BH coding audits and disputes experience.
• Experience with CPT/HCPCS and related guidelines.
• Strong written and verbal communication.

Responsibilities

• Audit outpatient Behavioral Health disputes with CPT/HCPCS coding.
• Collaborate across departments to ensure timeliness and accuracy.
• Communicate dispute outcomes to providers in a professional manner.
• Adhere to coding guidelines and industry best practices.

Skills

CPC or CCS Certification

CPT/HCPCS auditing

Behavioral Health claims reading

Behavioral Health coding audits

Microsoft Office

Independent work

Excellent communication

Education

Associate's Degree or higher in HIM

Tools

Microsoft Office

Job description

Humana Inc. is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes in a metrics-driven, remote environment.

This role sits on the PPI Coding Disputes Team and focuses on outpatient BH coding disputes with CPT/HCPCS assignments. You will review disputes, ensure accuracy and timeliness, collaborate with coding professionals across departments, and communicate outcomes to providers in a professional manner.