Tag: Humana

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 Out...