Remote Behavioral Health Coding Auditor: Outpatient Disputes

Humana; Tallahassee (FL); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits effective day 1

401(k) retirement savings plan with-em

Tuition assistance

Scholarships for eligible dependents

Parental and caregiver leave

Employee charity matching program

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 Behavioral Health coding disputes and collaborates across the Disputes Team to ensure accurate, compliant outcomes.

The ideal candidate will have CPT/HCPCS auditing experience, CPC/CCS certification, and 3+ years in BH coding audits, with strong communication and independence. Travel may be required for training or meetings.

Qualifications

• CPC or CCS certification required.
• CPT/HCPCS auditing experience.
• 1+ years' experience reading Behavioral Health claims.
• 3+ years' experience performing Behavioral Health coding audits.
• Proficiency with Microsoft Word, PowerPoint, and Excel.
• Ability to work independently and communicate clearly.
• Excellent written and verbal communication skills.

Responsibilities

• Audit outpatient Behavioral Health coding disputes to ensure accuracy.
• Communicate dispute outcomes to providers professionally.
• Collaborate with coding professionals across departments.
• Ensure timeliness, compliance, and quality in disputes.
• Balance multiple disputes and prioritize effectively.

Skills

CPC/CCS Certification

CPT/HCPCS auditing

Behavioral Health claims reading

Behavioral Health audits

Independence & initiative

Communication skills

Education

Associate's Degree or higher in Health Information Management (HIM)

Tools

Microsoft Office

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 Behavioral Health coding disputes and collaborates across the Disputes Team to ensure accurate, compliant outcomes.

The ideal candidate will have CPT/HCPCS auditing experience, CPC/CCS certification, and 3+ years in BH coding audits, with strong communication and independence. Travel may be required for training or meetings.