Remote Behavioral Health Coding Auditor (Outpatient Disputes)

Humana; Harrisburg (Dauphin County); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits day 1

Paid time off

401(k) with match

Tuition assistance

Scholarships for dependents

Parental leave

Employee charity matching

Career development opportunities

Job summary

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle disputes in a metrics-driven environment. This remote role focuses on CPT/HCPCS coding disputes and requires extensive BH coding audit expertise.

You will work with the Disputes Team to ensure timely, compliant outcomes and clear communication with providers. The position demands 3+ years of BH coding audits and 1+ year reading BH claims, plus strong MS Office skills.

Qualifications

• CPC or CCS Certification required.
• CPT/HCPCS auditing experience required.
• 1+ years reading Behavioral Health claims.
• 3+ years conducting BH coding audits in health insurance or hospital settings.

Responsibilities

• Review and decide on outcomes of outpatient Behavioral Health coding disputes.
• Ensure accuracy and compliance with coding guidelines for disputes.
• Communicate disputes outcomes to providers clearly and professionally.
• Collaborate with team members to achieve timely dispute resolutions.

Skills

CPC or CCS Certification

CPT/HCPCS auditing

Behavioral Health claims reading

BH coding audits experience

Microsoft Office

Independent worker

Communication skills

Education

Associate's Degree or higher in HIM

Job description

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle disputes in a metrics-driven environment. This remote role focuses on CPT/HCPCS coding disputes and requires extensive BH coding audit expertise.

You will work with the Disputes Team to ensure timely, compliant outcomes and clear communication with providers. The position demands 3+ years of BH coding audits and 1+ year reading BH claims, plus strong MS Office skills.