Remote Medicare Coding & Payment Integrity Pro

Humana Inc; Dover (DE); On-site; USD 65,000 - 89,000; Full time

Job summary

Humana Inc. is seeking a Payment Integrity Professional 2 to help ensure correct claim payment by applying coding guidelines and identifying data anomalies. The role requires independent decision-making, collaboration across departments, and a focus on cost reduction within the Medicare/Medicaid coding framework.

The position is remote/work-at-home with occasional travel to Humana offices for training or meetings. Typical hours are Monday–Friday, and compensation includes a bonus plan.

Qualifications

• Certified Professional Coder with AHIMA or AAPC certification.
• Strong knowledge of CPT, HCPCS and ICD code sets.
• Excellent analytical thinking and attention to detail.

Responsibilities

• Research and apply coding guidelines to ensure correct claim payment.
• Identify and validate new code edit opportunities to reduce costs.
• Collaborate with Code Edit Management, stakeholders and vendors; drive process improvements.

Skills

Certified Professional Coder

CMS guidelines

Analytical thinking

Attention to detail

Independent worker

Public speaking

Job description

Humana Inc. is seeking a Payment Integrity Professional 2 to help ensure correct claim payment by applying coding guidelines and identifying data anomalies. The role requires independent decision-making, collaboration across departments, and a focus on cost reduction within the Medicare/Medicaid coding framework.

The position is remote/work-at-home with occasional travel to Humana offices for training or meetings. Typical hours are Monday–Friday, and compensation includes a bonus plan.