Vacancy caducado!
DescriptionThe 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.ResponsibilitiesThe 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 Hours40Humana 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=HumanaWebsite.
Vacancy caducado!