Remote Medical Coding Auditor - APC/CPT Specialist

Humana Inc; Honolulu (HI); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Remote work

Job summary

Humana Inc in a remote Medical Coding Auditor role offers a path to impact provider payments accuracy. You will verify CPT/HCPCS codes, review documentation, and conduct CPT/HCPCS procedure reviews across outpatient settings, with emphasis on APC coding.

You will handle encoders, maintain confidentiality, and participate in quality initiatives while working mostly from home. Typical hours Monday–Friday with travel for training as needed; strong attention to detail, independent judgment, and

Qualifications

• CPC/COC/CCS or RHIA/RHIT certification with 3+ years post-certification.
• 3+ years post-certification in outpatient surgeries and procedures.
• Strong CPT/HCPCS coding knowledge.
• Experience reading and coding from operative reports.
• Chemotherapy/therapeutic infusion experience.
• Solid judgment, high attention to detail, and ability to work independently.
• Strong written and verbal communication; proficient with Word/Excel.

Responsibilities

• Verify accuracy and specificity of procedure codes based on services.
• Review documentation to ensure clinical criteria and APC/outpatient criteria met.
• Use encoders and coding resources; perform CPT/HCPCS reviews.
• Conduct peer reviews and provide reports as needed.
• Maintain patient/physician confidentiality per HIPAA and guidelines.
• Stay current with ICD-10 and CPT guidelines; handle claim information entry.
• Support process and quality improvement initiatives.

Skills

CPC

COC

CCS

RHIA

RHIT

CPT/CPT coding

PHPCS coding

Operative reports

Chemotherapy coding

Microsoft Office

Analytical skills

Attention to detail

Tools

3M Coder software

Encoders

Job description

Humana Inc in a remote Medical Coding Auditor role offers a path to impact provider payments accuracy. You will verify CPT/HCPCS codes, review documentation, and conduct CPT/HCPCS procedure reviews across outpatient settings, with emphasis on APC coding.

You will handle encoders, maintain confidentiality, and participate in quality initiatives while working mostly from home. Typical hours Monday–Friday with travel for training as needed; strong attention to detail, independent judgment, and