Remote Behavioral Health Coding Auditor - Outpatient

Humana; Topeka (KS); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits effective day 1

Paid time off

401(k) with employer match

Tuition assistance

Scholarships for eligible dependents

Parental and caregiver leave

Employee charity matching program

NRGs (Network Resource Groups)

Career development opportunities

Job summary

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes in a metrics‑driven environment. This remote role focuses on outpatient Behavioral Health coding disputes and is part of the PPI Coding Disputes Team, reporting to the Manager.

The candidate will audit CPT/HCPCS assignments, ensure accuracy and compliance with coding guidelines, and communicate outcomes professionally to providers. Strong collaboration and documentation skills are required.

Qualifications

• CPC or CCS certification required.
• Experience reading Behavioral Health claims.
• 3+ years performing Behavioral Health coding audits in health insurance or hospital settings.
• CPT/HCPCS auditing experience required.

Responsibilities

• Handle provider disputes in outpatient Behavioral Health coding.
• Ensure accuracy and timeliness of disputes conclusions.
• Communicate disputes outcomes to providers clearly and concisely.
• Collaborate across departments to improve coding dispute processes.

Skills

CPC/CCS Certification

CPT/HCPCS auditing

Behavioral Health claims reading

Behavioral Health coding audits

MS Office Suite

Independent work

Communication skills

Education

Associate's Degree or higher in HIM

Tools

Microsoft Office Suite

Job description

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes in a metrics‑driven environment. This remote role focuses on outpatient Behavioral Health coding disputes and is part of the PPI Coding Disputes Team, reporting to the Manager.

The candidate will audit CPT/HCPCS assignments, ensure accuracy and compliance with coding guidelines, and communicate outcomes professionally to providers. Strong collaboration and documentation skills are required.