Humana Medical Coding Auditor Evaluation & Management Required - Remote EST/CST in Remote, Mississippi

Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guideline are met. 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 correct CPT coding 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. Review medical documentation for clinical indicators to ensure correct coding guidelines are met Perform CPT/HCPCS code reviews for professional Evaluation and Management services: Inpatient services, office visit services, ER, Consultation services, Annual Wellness Services, and minor procedures Utilize encoders and various coding resources Maintain current working knowledge of ICD-9, ICD-10 and CPT coding principles, government regulation, protocols Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release of information Required Qualifications CPC, CCS, COC, RHIA, or RHIT Certification either through AAPC or AHIMA Minimum of 3 years of post-certification experience auditing Professional Evaluation and Management Services - Inpatient, Office, ER, and minor procedures Strong attention to detail Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel Can work independently and determine appropriate courses of action Ability to handle multiple priorities Capacity to maintain confidentiality Excellent communication skills both written and verbal Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Five years of post-certification experience auditing Professional Evaluation and Management Services - Inpatient, Office, ER, and minor procedures Bachelor's Degree- Healthcare Related Experience with the Claims Life Cycle Experience in Select Coder, 3M Scheduled Weekly Hours 40 Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website. Source link Apply tot his job Apply To this Job