Remote Outpatient Behavioral Health Coding Auditor - Disputes

Humana; Columbia (SC); A distancia; USD 59.000 - 81.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health benefits from day 1

Paid time off & holidays

Recognition pay

401(k) with employer match

Tuition assistance

Scholarships for dependents

Parental & caregiver leave

Employee charity matching

Network Resource Groups

Career development opportunities

Descripción de la vacante

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, reporting to the Manager.

The auditor collaborates across departments to ensure timely, compliant dispute outcomes. Requirements include CPC/CCS, CPT/HCPCS auditing, 1+ year BH claims reading, and 3+ years BH coding disputes experience, with strong MS Office skills.

Formación

• CPC or CCS certification required.
• CPT/HCPCS auditing experience required.
• 1+ years reading Behavioral Health claims.
• 3+ years performing Behavioral Health coding audits and disputes.
• Proficient with Word, PowerPoint and Excel.
• Ability to work independently and determine actions.
• Excellent written and verbal communication.

Responsabilidades

• Serve as a seasoned medical coding auditor for outpatient Behavioral Health disputes.
• Ensure accuracy and compliance of coding reviews according to guidelines.
• Communicate dispute outcomes to providers professionally.
• Juggle multiple priorities and ensure timely completion of disputes.

Conocimientos

CPC/CCS Certification

CPT/HCPCS auditing

BH claims reading

BH coding audits

Independent work

Excellent communication

Educación

Associate's Degree in HIM

Herramientas

Microsoft Word

Microsoft PowerPoint

Microsoft Excel

Descripción del empleo

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, reporting to the Manager.

The auditor collaborates across departments to ensure timely, compliant dispute outcomes. Requirements include CPC/CCS, CPT/HCPCS auditing, 1+ year BH claims reading, and 3+ years BH coding disputes experience, with strong MS Office skills.