Remote Outpatient Behavioral Health Coding Auditor

Humana; Charleston (WV); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits (day 1) and PTO

401(k) with employer match

Tuition assistance

Scholarships for dependents

Parental and caregiver leave

Employee charity matching

Job summary

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle disputes in a metrics‑driven environment. This remote role focuses on CPT/HCPCS coding audits within the Disputes Team and reports to the Manager. The position emphasizes timeliness, compliance, and quality in provider disputes.

The candidate will review Behavioral Health claims, adhere to guidelines, and communicate outcomes to providers clearly. Travel to Humana offices may be required for training.

Qualifications

• CPC or CCS certification required.
• 3+ years’ experience performing Behavioral Health coding audits.
• 1+ years’ experience reading and interpreting Behavioral Health claims.

Responsibilities

• Audit outpatient Behavioral Health coding disputes for accuracy and compliance.
• Communicate disputes outcomes to providers professionally and concisely.
• Collaborate with coding professionals across departments to ensure timeliness and quality.
• Adhere to coding guidelines and industry best practices in all reviews.

Skills

CPC/ CCS Certification

CPT/ HCPCS auditing

Behavioral Health claims reading

Behavioral Health coding audits

Microsoft Office (Word, PowerPoint, 0f

Education

Associate degree or higher in HIM

Tools

Microsoft Office

Job description

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle disputes in a metrics‑driven environment. This remote role focuses on CPT/HCPCS coding audits within the Disputes Team and reports to the Manager. The position emphasizes timeliness, compliance, and quality in provider disputes.

The candidate will review Behavioral Health claims, adhere to guidelines, and communicate outcomes to providers clearly. Travel to Humana offices may be required for training.