Outpatient Medical Coding Auditor Author by Humana

Profile

Description

Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of a modern start-up and backed by the insights and scale of Humana, Author is pioneering a customer-centered experience designed to foster trusting relationships with members to help them achieve their best health.

Dedicated to simplifying the healthcare experience and helping people navigate their healthcare journey, Author is leveraging digital technologies to eliminate fragmentation and systematic friction for members and providers.

We are seeking individuals who are passionate about solving tough problems as we forge a new path for the healthcare industry. As a member of the Author team, you will have the opportunity to make a difference in the lives and health of the members we serve.

The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Medical Coding Auditor confirms appropriate diagnosis related group (DRG) assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications


CPC, CIC, COC, and/or CPMA Certification or equivalent
MS-DRG and CPT auditing experience, minimum 1 year
Outpatient coding experience, minimum 1 year
Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications


Bachelor's Degree
Inpatient medical coding experience as well


Additional Information

#Author

Scheduled Weekly Hours

40

Company info

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