Remote Outpatient Behavioral Health Coding Auditor

Humana; Washington (District of Columbia); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits from day 1

401(k) with employer match

Tuition assistance

Paid time off

Job summary

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle disputes in a metrics-driven environment. This remote role supports the PPI Coding Disputes Team, focusing on CPT/HCPCS coding in behavioral health.

The candidate will review claims, communicate decisions to providers, and ensure timely, compliant dispute outcomes while maintaining high quality standards.

Qualifications

• CPC or CCS certification required or preferred.
• 3+ years' experience auditing Behavioral Health coding in health insurers or hospitals.
• 1+ years' experience reading Behavioral Health claims.
• Proficient in CPT/HCPCS coding guidelines and disputes.

Responsibilities

• Audit and review outpatient behavioral health coding disputes for accuracy and timeliness.
• Communicate dispute outcomes to providers in a professional manner.
• Collaborate with team members to ensure consistency and quality.
• Maintain compliance with coding guidelines and industry standards.

Skills

CPC/CCS Certification

CPT/HCPCS auditing

Behavioral Health claims

BH coding audits

Microsoft Office

Independent work

Excellent communication

Education

Associate's Degree 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 supports the PPI Coding Disputes Team, focusing on CPT/HCPCS coding in behavioral health.

The candidate will review claims, communicate decisions to providers, and ensure timely, compliant dispute outcomes while maintaining high quality standards.