Remote Outpatient Behavioral Health Coding Auditor

Humana; Baton Rouge (LA); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits from day 1

Paid time off and holidays

401(k) with employer match

Tuition assistance

Scholarships for dependents

Parental and caregiver leave

Employee charity matching program

Career development opportunities

Job summary

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes in a results-driven, metrics-focused environment. This remote position focuses on outpatient behavioral health coding disputes as part of the Disputes Team.

Responsibilities include auditing CPT/HCPCS, communicating outcomes to providers, and ensuring timely, compliant resolutions. Requires CPC/CCS certification and 3+ years in BH coding audits.

Qualifications

• CPC or CCS certification is required.
• 1+ years' experience reading Behavioral Health claims.
• 3+ years' experience performing Behavioral Health coding audits and disputes.
• Auditing CPT/HCPCS with attention to accuracy and timeliness.
• Proficient in Word, PowerPoint, and Excel.

Responsibilities

• Audit outpatient Behavioral Health coding disputes for accuracy and compliance.
• Communicate disputes outcomes to providers professionally.
• Collaborate with care teams to ensure timely resolution of disputes.
• Maintain high-quality standards and adhere to coding guidelines.
• Manage multiple audits and prioritize workload.

Skills

CPC or CCS Certification

CPT/HCPCS auditing

Behavioral Health claims reading

Behavioral Health coding audits

MS Office

Independent work

Excellent communication

Education

Associate's Degree in HIM

Associate's Degree or higher in HIM (preferred)

Tools

MS Office Suite

Job description

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes in a results-driven, metrics-focused environment. This remote position focuses on outpatient behavioral health coding disputes as part of the Disputes Team.

Responsibilities include auditing CPT/HCPCS, communicating outcomes to providers, and ensuring timely, compliant resolutions. Requires CPC/CCS certification and 3+ years in BH coding audits.