Remote Inpatient Coding Auditor (MSDRG)

Humana Inc; San Juan (PR); Remote; USD 71,000 - 98,000; Full time

Job summary

Humana Inc. is seeking an Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and to ensure accurate DRG assignments.

The role involves analyzing complex medical records, handling provider disputes, and maintaining high data accuracy in a remote, metrics-driven environment. Qualified candidates will hold RHIA/RHIT/CCS certifications and have MS-DRG coding/auditing experience, with strong reading/interpreting claims skills and proficiency in MS Office.

Qualifications

• RHIA, RHIT or CCS Certification.
• MS-DRG coding/auditing experience.
• Experience reading and interpreting claims.
• Experience in inpatient coding reviews/audits in health insurance and/or hospital settings.
• Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel.
• Strong attention to detail.
• Can work independently and determine appropriate course of action.
• Ability to handle multiple priorities.
• Capacity to maintain confidentiality.
• Excellent communication skills both written and verbal.

Skills

RHIA/RHIT/CCS

MS-DRG coding

Claims interpretation

Inpatient coding audits

Microsoft Word

PowerPoint

Excel

Attention to detail

Independence

Multitasking

Confidentiality

Communication (written)

Communication (verbal)

Tools

Microsoft Word

PowerPoint

Excel

Job description

Humana Inc. is seeking an Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and to ensure accurate DRG assignments.

The role involves analyzing complex medical records, handling provider disputes, and maintaining high data accuracy in a remote, metrics-driven environment. Qualified candidates will hold RHIA/RHIT/CCS certifications and have MS-DRG coding/auditing experience, with strong reading/interpreting claims skills and proficiency in MS Office.