Remote Medical Coding Auditor CPT/ICD-10

DaMar Staffing; Lincoln (NE); On-site; USD 59,000 - 85,000; Full time

Benefits offered by this job

Remote work

Job summary

Humana is seeking a remote Medical Coding Auditor to join the Outpatient Facility/APC Coding Team. You will verify codes, review documentation, and ensure proper CPT/HCPCS alignment while maintaining patient confidentiality.

The role requires CPC/COC/CCS/ROCC/RHIA/RHIT certification with at least 3 years post-certification experience, strong CPT/HCPCS knowledge, and the ability to work independently with attention to detail and solid communication.

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 and coding from operative reports.
• Chemotherapy and/or Therapeutic Infusion experience.
• Demonstrated ability to exercise solid judgment and discretion in handling information.
• Strong attention to detail, ability to work independently and manage multiple priorities.
• Proficiency with Microsoft Word and 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 procedures meet 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 HIPAA guidelines
• 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

Coding certifications

CPT/HCPCS knowledge

Operative report coding

Chemotherapy infusion experience

Judgment and discretion

Independent work

Communication skills

Microsoft Word

Microsoft Excel

Education

CPC/COC/CCS/ROCC/RHIA/RHIT certification

Tools

Microsoft Word

Microsoft Excel

Job description

Humana is seeking a remote Medical Coding Auditor to join the Outpatient Facility/APC Coding Team. You will verify codes, review documentation, and ensure proper CPT/HCPCS alignment while maintaining patient confidentiality.

The role requires CPC/COC/CCS/ROCC/RHIA/RHIT certification with at least 3 years post-certification experience, strong CPT/HCPCS knowledge, and the ability to work independently with attention to detail and solid communication.