Remote Coding & Payment Integrity Specialist

Humana Inc; Honolulu (HI); On-site; USD 65,000 - 89,000; Full time

Benefits offered by this job

Remote work

Job summary

Humana, Inc. is seeking a Payment Integrity Professional 2 to help reduce costs by applying code editing guidelines and analyzing data anomalies to ensure correct claim payments. This role requires expert coding knowledge specific to Medicare and Medicaid and independent decision making.

The position is remote/work-at-home with occasional travel for training or meetings, typical hours Monday-Friday, 40 hours. Compensation ranges from $65,000 to $88,600 per year plus bonus eligibility.

Qualifications

• Certified Professional Coder with AHIMA or AAPC certification.
• Minimum 2 years of coding guideline experience with claims.
• Strong CPT, HCPCS and ICD knowledge.
• Deep CMS/Medicaid guidelines knowledge and benchmarks.
• Able to present to a large audience.
• Detail oriented and able to work independently.

Responsibilities

• Research and determine appropriate actions with minimal direction.
• Collaborate across departments and with external vendors.
• Identify new code edit opportunities to ensure correct pay on first submission.
• Drive process improvements and ensure smooth run of business.

Skills

Certified Professional Coder

CMS guidelines knowledge

Analytical thinking

Attention to detail

Independent worker

Public speaking

Job description

Humana, Inc. is seeking a Payment Integrity Professional 2 to help reduce costs by applying code editing guidelines and analyzing data anomalies to ensure correct claim payments. This role requires expert coding knowledge specific to Medicare and Medicaid and independent decision making.

The position is remote/work-at-home with occasional travel for training or meetings, typical hours Monday-Friday, 40 hours. Compensation ranges from $65,000 to $88,600 per year plus bonus eligibility.