Remote Medical Coding Auditor – Outpatient APC Specialist

DaMar Staffing; Montgomery (AL); On-site; USD 59,000 - 81,000; Full time

Benefits offered by this job

Remote work

Travel for training

Job summary

Humana, Inc. is hiring a Medical Coding Auditor to review outpatient claims and ensure CPT/HCPCS coding accuracy in a remote environment. You will verify codes, assess documentation quality, and contribute to cost containment and process improvements within a HIPAA-compliant framework.

The role emphasizes independence, strong CPT/HCPCS knowledge, and post-certification experience in outpatient procedures, with occasional travel for training and meetings.

Qualifications

• CPC, COC, CCS, ROCC, RHIA, or RHIT Certification with a minimum of 3 years post-certification experience
• Minimum of 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

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 Certification

COC Certification

CCS Certification

RHIA/RHIT

CPT/HCPCS coding

Operative reports coding

Chemotherapy infusion

Attention to detail

Independent work

Education

Medical Coding Certification

Healthcare degree (associ/ bachelor's)

Tools

3M Coder software

Job description

Humana, Inc. is hiring a Medical Coding Auditor to review outpatient claims and ensure CPT/HCPCS coding accuracy in a remote environment. You will verify codes, assess documentation quality, and contribute to cost containment and process improvements within a HIPAA-compliant framework.

The role emphasizes independence, strong CPT/HCPCS knowledge, and post-certification experience in outpatient procedures, with occasional travel for training and meetings.