Unknown Company is hiring a Code Edit Disputes Medical Coder

Humana is looking for a Code Edit Disputes Medical Coder to join our team. In this role, you will review and educate providers on disputes regarding adjudicated claims with code editing denials or financial recoveries. You'll be part of a caring community focused on putting health first and improving consumer experiences.

What You'll Do

• Review and educate providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery.
• Extract clinical information from a variety of medical records and assign appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records.
• Analyze, enter, and manipulate databases.
• Respond to or clarify internal requests for medical information.
• Make decisions focusing on methods, tactics and processes for completing administrative tasks/projects.
• Exercise discretion and judgment in prioritizing requests and interpreting/adapting procedures, processes and techniques.

What We're Looking For

• Coding Certification required: AAPC CPC (no Apprentice).
• Minimum of 3 years' experience as a Certified Medical Coder.
• Demonstrate ability to problem-solve complex coding issues.
• Experience with Medicare and Medicaid coding guidelines.
• Strong data entry and attention to detail skills with the ability to manage multiple tasks in a fast-paced setting with competing priorities.
• Intermediate experience with Microsoft Word and Excel, Outlook, and Teams.

Nice to Have

• Bachelor's Degree.
• 5 or more years of experience as a Certified Medical Coder.
• CPMA certification.
• MS-DRG auditing or APR auditing experience.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
• Experience in a production driven environment.

Technical Stack

• Microsoft Word
• Microsoft Excel
• Outlook
• Teams

Benefits & Compensation

• Compensation: $48,300 - $65,900 per year
• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.
• Bi-weekly payment for internet expense for associates in California, Illinois, Montana, or South Dakota.
• Telephone equipment provided.

Work Mode

This is a remote position open to candidates within the United States.

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.