Remote Inpatient Coding Auditor (MS-DRG)

Humana; United States; Remote; USD 71,000 - 98,000; Full time

Job summary

Humana is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims, assign DRGs, and ensure accurate reimbursements. This remote role requires RHIA/RHIT/CCS certification and MS-DRG auditing experience. You will analyze claims, maintain HIPAA/compliance, and collaborate with internal teams.

The position offers standard business hours with an option for occasional travel to Humana offices for training. Strong communication and attention to detail are essential.

Qualifications

• RHIA, RHIT or CCS certification required; should have held at least one for 4 years.
• MS-DRG coding/auditing experience.
• Experience reading and interpreting claims.
• Experience in inpatient coding reviews/audits in health insurance or hospital settings.
• Working knowledge of Word, PowerPoint and Excel.
• Strong attention to detail.
• Ability to work independently and determine appropriate course of action.
• Capacity to manage multiple priorities and maintain confidentiality.
• Excellent written and verbal communication skills.

Responsibilities

• Review inpatient hospital claims for proper reimbursement.
• Analyze and assign DRG using ICD-10-CM and CPT.
• Review provider disputes in a metrics-driven environment.
• Maintain confidentiality and handle PHI securely.
• Collaborate with internal teams as needed.

Skills

MS-DRG coding

Claims interpretation

Inpatient coding audits

Attention to detail

Independent work

Multitasking

Confidentiality

Communication skills

Education

RHIA Certification

RHIT Certification

CCS Certification

Tools

Microsoft Office

Job description

Humana is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims, assign DRGs, and ensure accurate reimbursements. This remote role requires RHIA/RHIT/CCS certification and MS-DRG auditing experience. You will analyze claims, maintain HIPAA/compliance, and collaborate with internal teams.

The position offers standard business hours with an option for occasional travel to Humana offices for training. Strong communication and attention to detail are essential.