Inpatient Medical Coding Auditor for Humana reviewing inpatient hospital claims for proper reimbursement and contributing to cost reduction in healthcare. Remote position with occasional travel to office.
Responsibilities
extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes to patient records
reviews inpatient hospital claims for proper reimbursement
handles provider disputes in a result-oriented and metrics-driven environment
contributes to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems
ensures correct claims payment and appropriate diagnosis related group (DRG) assignments
analyzes, enters and manipulates database
responds to or clarifies internal requests for medical information
Requirements
RHIA, RHIT or CCS Certification (should have held at least one of these qualifications for 4 years)
MS-DRG coding/auditing experience
Experience reading and interpreting claims
Experience in performing inpatient coding reviews/ audits in health insurance and/or hospital settings
Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
Strong attention to detail
Can work independently and determine appropriate course of action
Ability to handle multiple priorities
Capacity to maintain confidentiality
Excellent communication skills both written and verbal.
Benefits
medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
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