DME/Outpatient Medical Coding Auditor
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Job Description
Experienced auditor for DME coding disputes, ensuring accuracy and compliance at Humana. Work remotely while collaborating with healthcare professionals for timely dispute resolutions.
Responsibilities:
- Handle provider disputes in a result-oriented and metrics-driven environment
- Ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality
- Consult and collaborate with coding professionals within and across departments
- Make coding decisions based on standard industry guidelines and best practices
- Manage multiple priorities, collaborate with peers and ensure timely completion of outpatient coding disputes
Requirements:
- CPC or CCS Certification
- CPT/ HCPCS auditing experience
- 1+ years' work experience reading and interpreting claims
- 3+ years' experience performing DME coding audits in health insurance and/or hospital settings and working coding-related disputes and trending results
- Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
- Can work independently and determine appropriate course of action
- Excellent communication skills both written and verbal
Benefits:
- Health benefits effective day 1
- Paid time off, holidays, volunteer time and jury duty pay
- Recognition pay
- 401(k) retirement savings plan with employer match
- Tuition assistance
- Scholarships for eligible dependents
- Parental and caregiver leave
- Employee charity matching program
- Network Resource Groups (NRGs)
- Career development opportunities
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