Remote Medical Coding Auditor CPT/APC Specialist

Humana Inc; Helena (MT); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Remote opportunity for role

Professional development & continued教育

Job summary

Humana, Inc. is seeking a Medical Coding Auditor to review outpatient claims for APC coding and CPT/HCPCS accuracy. This remote role requires CPC/COC/CCS/ROCC/RHIA/RHIT certification and 3+ years in outpatient coding, with experience in chemotherapy/infusion and operative reports.

You will work from home with occasional travel to Humana offices for training and meetings; typical hours are Monday–Friday, 8 hours per day, with some flexibility. Competitive pay and benefits offered.

Qualifications

• CPC, COC, CCS, ROCC, RHIA, or RHIT certification with at least 3 years post-certification experience.
• Minimum 3 years post-certification experience Outpatient Specialty Surgeries and Procedures.
• Strong knowledge of CPT/HCPCS coding.
• Experience reading & coding from operative reports.
• Chemotherapy and/or Therapeutic Infusion experience.
• Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information.
• Strong attention to detail, can work independently and determine appropriate course of action, & ability to handle multiple priorities.
• Comfortable working in a production-based work environment.
• Ability to work independently and manage workload.
• Strong written and verbal communication skills; strong analytical, organizational and time management skills.
• Working knowledge of Microsoft Office Programs (Word, Excel)

Responsibilities

• Verify and ensure the accuracy, completeness, specificity and appropriateness of procedure codes based on services rendered
• Review medical documentation for clinical indicators to ensure specific procedures meet clinical criteria and correct coding guidelines specific to APC and Outpatient Facility coding
• Utilize encoders and various coding resources
• Perform CPT/HCPCS Procedure reviews
• Conduct peer reviews to ensure compliance with coding guidelines and provide reports as needed
• Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release of information
• Maintain current working knowledge of ICD-10 and CPT coding guidelines, government regulation and protocols
• Complete appropriate system(s) entry regarding claim/encounter information
• Support and participate in process and quality improvement initiatives

Skills

CPC/COC/CCS/ROCC/RHIA/RHIT certs

CPT/HCPCS knowledge

Operative report coding

Infusion/chemotherapy coding

Independent judgment & prioritization

Strong communication

Microsoft Word/Excel

Tools

3M Coder software

Job description

Humana, Inc. is seeking a Medical Coding Auditor to review outpatient claims for APC coding and CPT/HCPCS accuracy. This remote role requires CPC/COC/CCS/ROCC/RHIA/RHIT certification and 3+ years in outpatient coding, with experience in chemotherapy/infusion and operative reports.

You will work from home with occasional travel to Humana offices for training and meetings; typical hours are Monday–Friday, 8 hours per day, with some flexibility. Competitive pay and benefits offered.