Role Overview
A well-known healthcare company, Humana, is seeking a Medical Coding Auditor to review and validate medical claims for accuracy and compliance with coding guidelines such as ICD-10-CM, CPT, and HCPCS. Working remotely and full time, this professional will verify the alignment of codes with clinical documentation, identify appropriate claim payment procedures, and support the accuracy of provider contract payments. The individual in this position will also conduct peer reviews, respond to internal queries for medical information, and follow established protocols to ensure data integrity.
Qualifications and Requirements
- CPC, COC, CCS, ROCC, RHIA, or RHIT certification with at least 3 years of post-certification experience
- Minimum of 3 years of recent experience in Outpatient Specialty Surgeries and Procedures
- Proficiency in CPT/HCPCS coding and experience coding from operative reports
- Familiarity with chemotherapy/therapeutic infusion coding
- Strong attention to detail, time management, and ability to handle multiple priorities
- Comfortable with a production-based environment
- Working knowledge of Microsoft Office applications
- Preferred qualifications include 5+ years of coding experience, APC coding expertise, and familiarity with 3M Coder software
Compensation and Benefits
- Estimated salary range: $59,300–$80,900 per year, with potential for an incentive bonus
- Comprehensive benefits supporting whole-person well-being, including medical, dental, and vision coverage, 401(k), paid time off, and other programs
- Remote work arrangement with a typical Monday–Friday schedule
- Professional development resources and ongoing education opportunities
Career Growth and Company Culture
Humana emphasizes professional growth and values each team member’s contribution to the healthcare sector. The organization promotes a culture focused on putting health first by fostering collaboration, respect, and continuous learning. Employees can expect a supportive, inclusive environment that encourages skill development and engagement in process improvement initiatives.
About Humana
Humana Inc. (NYSE: HUM) is a healthcare organization dedicated to improving well-being and accessibility of care. Through various insurance services and CenterWell healthcare services, Humana focuses on delivering the right resources at the right time to individuals with diverse healthcare needs. The company upholds inclusive hiring practices and is an Equal Opportunity Employer, offering competitive benefits and a range of opportunities for career advancement.