Remote Outpatient Behavioral Health Coding Auditor

Humana; Providence (RI); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Recognition pay

401(k)

Tuition assistance

Scholarships for dependents

Parental leave

Caregiver leave

Charity matching

NRGs

Career development

Job summary

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to join the Disputes Team. The role focuses on CPT/HCPCS coding disputes and requires strong auditing expertise, accuracy, and able to communicate outcomes to providers.

You'll work in a remote, results-driven environment with responsibilities including reviewing Behavioral Health claims, ensuring timeliness and compliance, and collaborating across departments. Travel to Humana offices may be required occasionally.

Qualifications

• CPC or CCS certification required.
• CPT/HCPCS auditing experience required.
• 1+ years' experience reading Behavioral Health claims.
• 3+ years' experience in BH coding audits and disputes.
• Proficient in Word, PowerPoint and Excel.

Responsibilities

• Review and adjudicate outpatient Behavioral Health coding disputes.
• Ensure accuracy and compliance with coding guidelines.
• Communicate disputes outcomes clearly to providers.
• Collaborate with cross‑functional teams to improve dispute outcomes.

Skills

CPC or CCS Certification

CPT/HCPCS auditing

Behavioral Health claims reading

Behavioral Health coding audits

Microsoft Office

Independent work

Excellent communication

Education

Associate's Degree in Health Information Management

Job description

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to join the Disputes Team. The role focuses on CPT/HCPCS coding disputes and requires strong auditing expertise, accuracy, and able to communicate outcomes to providers.

You'll work in a remote, results-driven environment with responsibilities including reviewing Behavioral Health claims, ensuring timeliness and compliance, and collaborating across departments. Travel to Humana offices may be required occasionally.