Remote Inpatient Coding Auditor — MS-DRG Specialist

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 for proper reimbursement, ensuring accurate DRG assignments and provider payments. This remote role requires MS-DRG coding experience and the ability to work with complex data.

Responsibilities include analyzing claims, responding to internal requests, and maintaining confidentiality while delivering high-quality audits in a metrics-driven environment. Some travel for training may be required.

Qualifications

• RHIA/RHIT/CCS certification required.
• MS-DRG coding/auditing experience preferred.
• Experience reading and interpreting inpatient claims.
• Experience performing inpatient coding reviews/audits in health insurance or hospital settings.
• Proficient with Microsoft Word, PowerPoint, Excel.

Responsibilities

• Review inpatient hospital claims for proper reimbursement.
• Analyze data and respond to internal information requests.
• Ensure correct DRG assignments and provider contract payments.
• Maintain confidentiality and work independently with minimal direction.

Skills

RHIA/RHIT/CCS certification

MS-DRG coding

Claims interpretation

Inpatient coding reviews

MS Office

Attention to detail

Independence

Multitasking

Confidentiality

Communication skills

Education

RHIA/RHIT/CCS Certification

Tools

MS Office

Job description

Humana is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement, ensuring accurate DRG assignments and provider payments. This remote role requires MS-DRG coding experience and the ability to work with complex data.

Responsibilities include analyzing claims, responding to internal requests, and maintaining confidentiality while delivering high-quality audits in a metrics-driven environment. Some travel for training may be required.