Remote Inpatient Coding Auditor – ICD-10/DRG Expert

DaMar Staffing; Madison (WI); On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off

Short-term and long-term disability

Life insurance

Job summary

Humana, a Fortune 100 Company, seeks an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will contribute to cost reduction by ensuring accurate payments and DRG assignments.

The role involves extracting clinical information, assigning ICD-10-CM/PCS codes, auditing quality, and collaborating across teams to improve accuracy. Remote work with occasional travel may be required.

Qualifications

• 4+ years of MSDRG coding auditing experience.
• RHIA, RHIT or CCS Certification (must have held certification for at least 4 years)
• Experience performing inpatient coding audits in a health insurance or hospital setting
• Experience reading and interpreting claims
• Proficiency in gathering or referencing data within different systems simultaneously

Responsibilities

• Review inpatient medical records and claims to ensure accurate coding and reimbursement
• Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes
• Audit coding quality and identify opportunities for improvement
• Investigate and resolve provider disputes with a fair, fact-based approach
• Analyze complex clinical documentation and coding scenarios
• Collaborate with other teams to clarify coding and medical information
• Contribute to cost savings by improving payment accuracy and reducing errors
• Use your skills to make an impact

Skills

MSDRG coding auditing

RHIA / RHIT / CCS

Inpatient coding audits

Reading claims

Data gathering across systems

Education

RHIA / RHIT / CCS Certification

Job description

Humana, a Fortune 100 Company, seeks an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will contribute to cost reduction by ensuring accurate payments and DRG assignments.

The role involves extracting clinical information, assigning ICD-10-CM/PCS codes, auditing quality, and collaborating across teams to improve accuracy. Remote work with occasional travel may be required.