Medical Coding Auditor
$59,300–$80,900 year
Remote · United States
Job Summary
Medical Coding Auditor role focused on reviewing outpatient facility claims, ensuring ICD-10-CM/CPT/HCPCS coding accuracy, performing CPT/HCPCS reviews, coding from operative reports, and supporting process/quality improvement initiatives. Remote work with occasional travel to Humana offices for training; requires CPC/COC/CCS/ROCC/RHIA/RHIT certification and 3+ years post-certification experience, strong attention to detail, independent judgment, and proficiency with CPT/HCPCS and ICD-10 coding guidelines.
Required Qualifications
- CPC, COC, CCS, ROCC, RHIA, or RHIT Certification with a minimum of 3 years post-certification experience
- Outpatient Specialty Surgeries and Procedures
- Strong knowledge of CPT/HCPCS coding
- Experience reading & coding from operative reports
- Chemotherapy and/or Therapeutic Infusion experience
- Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information
- Strong attention to detail, can work independently and determine appropriate course of action, & ability to handle multiple priorities
- Comfortable working in a production-based work environment
- Ability to work independently and manage workload
- Strong written and verbal communication skills; strong analytical, organizational and time management skills
- Working knowledge of Microsoft Office Programs (Word, Excel)
- Preferred Qualifications 5+ years prior coding experience
- Outpatient facility auditing experience
- Experience with coding/auditing Radiology, Gastroenterology, Urinary, Musculoskeletal, Integumentary, Anesthesia, General Surgery, Cardiology, Respiratory, Infusion, Interventional Radiology, Outpatient Itemized Bill reviews
- Ambulatory Payment Classification (APC) coding experience
- Radiation Oncology coding experience
- Experience in prospective payment methodologies
- Experience with the Claims Life Cycle including Accounts Receivable
- 3M Coder software experience
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