Remote Outpatient Behavioral Health Coding Auditor (Disputes)

Humana; Trenton (NJ); Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits day 1

Paid time off

Recognition pay

401(k) retirement savings plan

Tuition assistance

Scholarships for eligible dependents

Parental and caregiver leave

Employee charity matching program

NRGs

Career development opportunities

Job summary

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes within the PPI Coding Disputes Team. This remote role emphasizes accuracy, timeliness and compliance in CPT/HCPCS coding disputes.

You will collaborate with coding professionals across departments to ensure high-quality dispute outcomes and maintain strong documentation of findings and recommendations for providers.

Qualifications

• CPC or CCS Certification required.
• 1+ years reading Behavioral Health claims.
• 3+ years conducting BH coding audits and disputes.
• Experience with CPT/HCPCS coding guidelines.
• Proficient in Microsoft Office applications.

Responsibilities

• Review and adjudicate outpatient BH coding disputes with accuracy.
• Communicate outcomes to providers clearly and professionally.
• Collaborate across departments to ensure timely dispute resolution.
• Maintain audit quality and compliance with coding guidelines.

Skills

CPC or CCS Certification

CPT/HCPCS auditing

Behavioral Health claims reading

Behavioral Health coding audits

Microsoft Office skills

Independent worker

Excellent communication

Education

Associate's Degree or higher in Health Information Management (HIM)

Tools

Microsoft Word

PowerPoint

Excel

Job description

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes within the PPI Coding Disputes Team. This remote role emphasizes accuracy, timeliness and compliance in CPT/HCPCS coding disputes.

You will collaborate with coding professionals across departments to ensure high-quality dispute outcomes and maintain strong documentation of findings and recommendations for providers.