Remote Medical Coding Auditor - APC & CPT Specialist

DaMar Staffing; Columbia (SC); On-site; USD 59,000 - 81,000; Full time

Job summary

Humana is seeking a Medical Coding Auditor for the Outpatient Facility/APC Coding Team. This remote role requires CPT/HCPCS expertise, post-certification experience, and strong attention to detail.

Responsibilities include code validation, document review, and peer audits, with adherence to HIPAA and coding guidelines. Qualified candidates will have CPC/COC/CCS/RHIA/RHIT credentials, 3+ years post-cert experience, and familiarity with ICD-10 and APC coding rules.

Qualifications

• CPC/COC/CCS/RHIA/RHIT cert with 3+ years post-cert experience.
• Proven CPT/HCPCS coding knowledge; ability to read operative reports.
• Experience with Outpatient Specialty Surgeries/Procedures; chemotherapy or therapeutic infusion experience.

Responsibilities

• Verify and ensure accuracy, completeness, specificity and appropriateness of procedure codes based on services rendered.
• Review medical documentation for clinical indicators to ensure procedures meet criteria and CPT/HCPCS guidelines.
• Utilize encoders and coding resources; perform CPT/HCPCS procedure reviews.
• Conduct peer reviews to ensure compliance with coding guidelines and provide reports as needed.
• Maintain patient confidentiality and HIPAA compliance; follow all regulations.
• Maintain current knowledge of ICD-10 and CPT coding guidelines, government regulations and protocols.
• Complete system entries regarding claim/encounter information; support process and quality improvement initiatives.

Skills

CPC

COC

CCS

ROCC

RHIA

RHIT

CPT/HCPCS coding

operative reports

communication skills

Microsoft Word

Microsoft Excel

Tools

Microsoft Word

Microsoft Excel

Job description

Humana is seeking a Medical Coding Auditor for the Outpatient Facility/APC Coding Team. This remote role requires CPT/HCPCS expertise, post-certification experience, and strong attention to detail.

Responsibilities include code validation, document review, and peer audits, with adherence to HIPAA and coding guidelines. Qualified candidates will have CPC/COC/CCS/RHIA/RHIT credentials, 3+ years post-cert experience, and familiarity with ICD-10 and APC coding rules.