Remote Medical Coding Auditor – CPT/ICD Mastery

Humana; Lincoln (NE); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Remote work

Job summary

Humana is seeking a Medical Coding Auditor to review outpatient/APC coding and medical documentation for accuracy and compliance. The role emphasizes independent judgment, confidentiality, and adherence to coding guidelines across CPT/HCPCS, ICD-10-CM, and related regulations.

Remote work with occasional travel to Humana offices may be required. Responsibilities include verifying codes, auditing documentation, performing peer reviews, and supporting quality improvement efforts within the

Qualifications

• CPC/COC/CCS/RHIA/RHIT certification with post-certification experience
• Strong CPT/HCPCS coding knowledge
• Experience reading operative reports
• Therapy/Infusion coding experience helpful
• Attention to detail and ability to work independently
• Proficiency with Microsoft Word and Excel

Responsibilities

• Verify accuracy and completeness of procedure codes based on services rendered
• Review medical documentation to ensure clinical criteria for APC/outpatient facility coding
• Use coding resources and CPT/HCPCS references
• Perform CPT/HCPCS procedure reviews
• Conduct peer reviews and generate reports as needed
• Maintain patient/physician confidentiality per HIPAA
• Keep up-to-date with ICD-10 and CPT guidelines and regulations
• Record claim/encounter data in systems
• Support process and quality improvement initiatives

Job description

Humana is seeking a Medical Coding Auditor to review outpatient/APC coding and medical documentation for accuracy and compliance. The role emphasizes independent judgment, confidentiality, and adherence to coding guidelines across CPT/HCPCS, ICD-10-CM, and related regulations.

Remote work with occasional travel to Humana offices may be required. Responsibilities include verifying codes, auditing documentation, performing peer reviews, and supporting quality improvement efforts within the