Remote Outpatient Behavioral Health Coding Auditor

Humana; Indianapolis (IN); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits from day 1

Paid time off & holidays

401(k) with employer match

Tuition assistance

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 metrics-driven environment. This remote role focuses on outpatient BH coding disputes within the PPI Coding Disputes Team and reports to the Manager.

You will review CPT/HCPCS coding, communicate outcomes to providers, and ensure timely, compliant dispute resolutions. Ideal candidates have 3+ years in BH coding audits, CPC/CCS certification, and strong Excel/Office skills.

Qualifications

• CPC or CCS certification is required.
• 1+ year reading Behavioral Health claims.
• 3+ years performing Behavioral Health coding audits and disputes.
• Proficient in MS Word, Excel, PowerPoint.

Responsibilities

• Audit outpatient Behavioral Health coding disputes for accuracy and compliance.
• Communicate dispute outcomes to providers clearly and professionally.
• Collaborate across departments to ensure timely resolution of disputes.

Skills

CPC/CCS Certification

CPT/HCPCS auditing

BH claims interpretation

BH coding audits

MS Office

Independent work

Communication skills

Education

Associate's Degree in HIM

Tools

Microsoft Office

Job description

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes in a metrics-driven environment. This remote role focuses on outpatient BH coding disputes within the PPI Coding Disputes Team and reports to the Manager.

You will review CPT/HCPCS coding, communicate outcomes to providers, and ensure timely, compliant dispute resolutions. Ideal candidates have 3+ years in BH coding audits, CPC/CCS certification, and strong Excel/Office skills.