Inpatient Medical Coding Auditor

Become a part of our caring community Humana , a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for improvement Investigate and resolve provider disputes with a fair, fact-based approach Analyze complex clinical documentation and coding scenarios Collaborate with other teams to clarify coding and medical information Contribute to cost savings by improving payment accuracy and reducing errors Use your skills to make an impact Required Qualifications 4+ years of MSDRG coding auditing experience RHIA, RHIT or CCS Certification (must have held certification for at least 4 years) Experience performing inpatient coding audits in a health insurance or hospital setting Experience reading and interpreting claims Proficiency in gathering or referencing data within different systems simultaneously Preferred Qualifications Experience in APDRG coding/auditing Experience in Financial Recovery Experience in a metric driven operational setting Additional Information WORK HOURS are Monday-Friday, 8 hours per day, 40 hours per week, and are scheduled between 6AM-6PM. Potential shift to be discussed during th