Remote Inpatient Coding Auditor – MS-DRG Expert

Humana; Pierre (SD); 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 ICD-10-CM and CPT codes, and ensure accurate DRG assignments for proper reimbursement. The role requires MS-DRG coding/auditing experience, attention to detail, and the ability to work remotely with periodic travel for training or meetings.

You will support cost reduction by improving provider contract payments and work within a metrics-driven environment while communicating clearly with

Qualifications

• RHIA, RHIT or CCS Certification required or held for 4 years.
• MS-DRG coding/auditing experience required.
• Experience reading and interpreting claims.
• Experience in inpatient coding reviews/audits in health insurance or hospital settings.
• Strong attention to detail and the ability to work independently.
• Excellent written and verbal communication skills.

Responsibilities

• Review inpatient hospital claims for proper reimbursement.
• Contribute to cost reduction by improving accuracy of DRG assignments.
• Analyze and manipulate databases; respond to internal requests for medical information.
• Follow established guidelines and procedures.

Skills

MS-DRG coding/auditing

Reading & interpreting claims

Inpatient coding reviews

Attention to detail

Independent work

Confidentiality

Verbal & written communication

Education

RHIA, RHIT or CCS Certification

Tools

Microsoft Word

Microsoft PowerPoint

Microsoft Excel

Job description

Humana is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM and CPT codes, and ensure accurate DRG assignments for proper reimbursement. The role requires MS-DRG coding/auditing experience, attention to detail, and the ability to work remotely with periodic travel for training or meetings.

You will support cost reduction by improving provider contract payments and work within a metrics-driven environment while communicating clearly with