Remote Outpatient Behavioral Health Coding Auditor

Humana; Santa Fe (NM); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Recognition pay

401(k) retirement savings plan

Tuition assistance

Scholarships for eligible dependents

Parental and caregiver leave

Employee charity matching

Network Resource Groups

Career development opportunities

Job summary

Humana is seeking an experienced medical coding auditor to handle outpatient behavioral health coding disputes in a remote capacity. You will collaborate with the Disputes Team to ensure timely, compliant, and high-quality dispute outcomes, leveraging CPT/HCPCS knowledge and industry guidelines.

The role offers a competitive benefits package, work-from-home flexibility, and opportunities to impact provider relations within a Fortune 100 company.

Qualifications

• CPC or CCS Certification.
• CPT/ HCPCS auditing experience.
• 1+ years' work experience reading and interpreting Behavioral Health claims.
• 3+ years' experience performing Behavioral Health coding audits in health insurance and/or hospital settings and working coding-related disputes and trending results.
• Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel.
• Can work independently and determine appropriate course of action.
• Excellent communication skills both written and verbal.

Responsibilities

• Consult with coding professionals to ensure timeliness, compliance, and quality of disputes outcomes.
• Communicate disputes outcomes to providers in a professional and concise manner.
• Manage multiple priorities and ensure timely completion of outpatient coding disputes.

Skills

CPC or CCS Certification

CPT/HCPCS auditing experience

Behavioral Health claims reading

Behavioral Health coding audits

MS Office (Word, PowerPoint, Excel)

Independent work

Excellent communication

Education

Associate's Degree in Health Information Management

Job description

Humana is seeking an experienced medical coding auditor to handle outpatient behavioral health coding disputes in a remote capacity. You will collaborate with the Disputes Team to ensure timely, compliant, and high-quality dispute outcomes, leveraging CPT/HCPCS knowledge and industry guidelines.

The role offers a competitive benefits package, work-from-home flexibility, and opportunities to impact provider relations within a Fortune 100 company.