Humana

Medical Coding Auditor

Humana

Louisville, KY, USA
Full-TimeDepends on ExperienceMid-LevelBachelors
Job Description

Are you a detail-oriented individual with a passion for healthcare? Do you excel at analyzing data and identifying trends? Look no further, Humana is seeking a skilled Medical Coding Auditor to join our team. As a leading healthcare company, Humana values accuracy and compliance in our medical coding processes. In this role, you will have the opportunity to utilize your expertise in medical coding to ensure the quality and accuracy of our coding practices. Join us in our mission to improve the health and well-being of our members by applying your skills and experience as a Medical Coding Auditor at Humana.

  1. Conduct audits of medical coding processes to ensure accuracy and compliance with industry standards and regulations.
  2. Analyze coding data and identify trends to improve coding practices and identify areas for improvement.
  3. Collaborate with coding team members to develop and implement corrective actions based on audit findings.
  4. Stay up-to-date on changes in coding guidelines and regulations to ensure compliance.
  5. Communicate audit findings and recommendations to management and coding team.
  6. Review medical records and coding documentation to ensure accuracy and completeness.
  7. Identify and report any potential fraud or abuse related to coding practices.
  8. Provide training and education to coding team members on coding guidelines and best practices.
  9. Utilize coding expertise to assist in resolving complex coding issues.
  10. Maintain confidentiality of all medical records and coding information.
  11. Continuously strive to improve coding processes and maintain high standards of accuracy.
  12. Collaborate with cross-functional teams to ensure alignment and consistency in coding practices.
  13. Represent Humana in a professional manner and uphold the company's values and mission.
  14. Adhere to all company policies and procedures related to medical coding and auditing.
  15. Perform other related duties as assigned by management.
Where is this job?
This job is located at Louisville, KY, USA
Job Qualifications
  • Certified Professional Medical Auditor (Cpma) Certification Or Equivalent.

  • Minimum Of 5 Years Experience In Medical Coding, Preferably In A Healthcare Insurance Setting.

  • Strong Knowledge Of Medical Coding Guidelines, Including Icd-10, Cpt, And Hcpcs.

  • Excellent Analytical And Critical Thinking Skills, With The Ability To Identify Coding Errors And Discrepancies.

  • Strong Communication Skills And Ability To Provide Clear And Concise Feedback To Coding Staff And Other Stakeholders.

Required Skills
  • Communication Skills

  • Time Management

  • Attention to detail

  • Analytical Thinking

  • Medical Terminology

  • Auditing skills

  • Problem-Solving

  • Documentation review

  • Coding Knowledge

  • Compliance Expertise

  • Coding Guidelines

Soft Skills
  • Communication

  • Conflict Resolution

  • Emotional Intelligence

  • Leadership

  • Time management

  • creativity

  • Teamwork

  • Active Listening

  • Adaptability

  • Problem-Solving

Compensation

According to JobzMall, the average salary range for a Medical Coding Auditor in Louisville, KY, USA is between $55,000 and $75,000 per year. This may vary depending on factors such as experience, education, and the specific employer.

Additional Information
Humana is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedAugust 13th, 2024
Apply BeforeAugust 19th, 2025
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About Humana

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.

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