Remote Outpatient Behavioral Health Coding Auditor Disputes

Humana; United States; Remote; USD 59,000 - 81,000; Full time

Benefits offered by this job

Health benefits day 1

401(k) with employer match

Paid time off and holidays

Tuition assistance

Scholarships for dependents

Parental and caregiver leave

Employee charity matching program

Career development opportunities

Job summary

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes within a metrics-driven environment. This remote role supports the Disputes Team, focusing on outpatient behavioral health coding disputes and ensuring accuracy, timeliness, and compliance.

The Auditor collaborates with coding professionals, reviews CPT/HCPCS decisions, and communicates outcomes to providers with clarity.

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.
• Proficient in Word, PowerPoint, and Excel.
• Excellent written and verbal communication; ability to work independently.

Responsibilities

• Audit outpatient Behavioral Health coding disputes and ensure accuracy.
• Communicate disputes outcomes to providers in a professional and concise manner.
• Collaborate with coding professionals across departments to ensure quality and timeliness.
• Manage multiple priorities to meet timeliness and quality objectives.

Skills

CPT/HCPCS auditing

Behavioral Health claims reading

Behavioral Health coding audits

Microsoft Office

Excellent communication

Independent work

Education

Associate’s Degree in HIM

Job description

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle provider disputes within a metrics-driven environment. This remote role supports the Disputes Team, focusing on outpatient behavioral health coding disputes and ensuring accuracy, timeliness, and compliance.

The Auditor collaborates with coding professionals, reviews CPT/HCPCS decisions, and communicates outcomes to providers with clarity.