Humana
Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.
Medical Coding Quality Auditor
6 days ago
🏄 California – Remote
🌽 Illinois – Remote
+2 more states
💵 $65k - $88.6k / year
⏰ Full Time
🟠 Senior
🔴 Lead
🔎 Auditor
🦅 H1B Visa Sponsor
Humana
Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.
📋 Description
• Conduct quality reviews on coding processes within the Payment Integrity organization • Focus on Interventional Radiology, DME, Evaluation and Management, and multiple specialties • Develop and implement policies, procedures, and methods to ensure operational quality and continuous improvement • Conduct training and coaching for staff and management • Maintain effective and collaborative communication with administration, stakeholders, and vendor partners • Understand department, segment, and organizational strategies and operating objectives • Make decisions regarding work methods with minimal direction • Follow established guidelines and procedures to ensure compliance with regulations
🎯 Requirements
• 5+ years of Evaluation and Management and DME • 7 years of Profee and Surgery Auditing • Medical coding certification from AAPC OR AHIMA (CPC, CCS, CIC, CPMA or equivalent) • Strong critical thinking skills • Prior experience reading and coding from medical records • Demonstrated ability to work independently and manage workload • Exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence, and commitment to the profession • Excellent writing, editing, interpersonal, planning, teamwork, and communication skills • Proficient in MS Office applications including Word, Excel, Outlook, PowerPoint • Prior experience working independently and determining appropriate courses of action • Demonstrated experience in effective communication with internal customers through both written and verbal communication
🏖️ Benefits
• Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off, company and personal holidays, volunteer time off • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Many other opportunities
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