Remote Inpatient Coding Auditor (RHIA/CCS)

DaMar Staffing; Sacramento (CA); On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Bonus incentive plan

Medical benefits

401(k) retirement plan

Job summary

Humana is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM/PCS and DRG codes, and resolve provider disputes. The role supports cost reduction by improving payment accuracy and the integrity of hospital claim payments.

Responsibilities include auditing records, analyzing complex documentation, and collaborating across teams to clarify medical information. Remote work with occasional travel may be required.

Qualifications

• 4+ years of MSDRG coding auditing experience.
• RHIA, RHIT or CCS certification (must have held for at least 4 years).
• Experience reading and interpreting claims.

Responsibilities

• Review inpatient medical records and claims to ensure accurate coding and reimbursement.
• Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes.
• Audit coding quality and identify opportunities for improvement.
• Investigate and resolve provider disputes with a fair, fact-based approach.
• Analyze complex clinical documentation and coding scenarios.
• Collaborate with other teams to clarify coding and medical information.
• Contribute to cost savings by improving payment accuracy and reducing errors.

Skills

MSDRG coding auditing

Inpatient coding audits

Claims review

Job description

Humana is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM/PCS and DRG codes, and resolve provider disputes. The role supports cost reduction by improving payment accuracy and the integrity of hospital claim payments.

Responsibilities include auditing records, analyzing complex documentation, and collaborating across teams to clarify medical information. Remote work with occasional travel may be required.