Remote Inpatient Coding Auditor: MS-DRG Expert

Humana; Harrisburg (Dauphin County); A distancia; USD 71.000 - 98.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Bonus incentive plan

Descripción de la vacante

Humana is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and to ensure accurate DRG assignments. This remote role may require occasional travel to Humana offices for training.

You will analyze records, resolve provider disputes, and contribute to cost reduction by improving payment accuracy. The role demands MS-DRG coding experience, strong attention to detail, and the ability to work independently in a metrics-driven

Formación

• RHIA, RHIT or CCS certification is required.
• MS-DRG coding/auditing experience is required.
• Experience reading and interpreting medical claims.
• Experience in inpatient coding reviews/audits in health insurance or hospital settings.
• Proficient with Word, PowerPoint and Excel.
• Strong attention to detail and ability to work independently.
• Ability to handle multiple priorities and maintain confidentiality.
• Excellent written and verbal communication skills.

Responsabilidades

• Review inpatient hospital claims for proper reimbursement.
• Handle provider disputes in a result- and metrics-driven environment.
• Contribute to cost reduction by improving DRG assignments and payment accuracy.
• Analyze, enter, and manipulate databases and respond to internal requests for information.

Conocimientos

MS-DRG coding/auditing experience

Reading and interpreting claims

Inpatient coding reviews/audits

Strong attention to detail

Excellent communication skills

Can work independently

Capacity to handle multiple priorities

Confidentiality

Educación

RHIA/ RHIT or CCS Certification

Herramientas

Microsoft Office

Descripción del empleo

Humana is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and to ensure accurate DRG assignments. This remote role may require occasional travel to Humana offices for training.

You will analyze records, resolve provider disputes, and contribute to cost reduction by improving payment accuracy. The role demands MS-DRG coding experience, strong attention to detail, and the ability to work independently in a metrics-driven