Inpatient Medical Coding Auditor
New
H
HumanaMedical coding
United StatesFull-TimeMiddle
Salary$71,100 - $97,800 per year
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Job Details
- Experience
- RHIA, RHIT or CCS Certification (should have held at least one of these qualifications for 4 years)
- Required Skills
- Microsoft ExcelPowerPoint
Requirements
- Hold an RHIA, RHIT, or CCS certification for at least four years.
- Have MS-DRG coding or auditing experience.
- Have experience reading and interpreting claims.
- Have experience performing inpatient coding reviews or audits in health insurance and/or hospital settings.
- Have working knowledge of Microsoft Word, PowerPoint, and Excel.
- Demonstrate strong attention to detail.
- Be able to work independently and determine an appropriate course of action.
- Be able to handle multiple priorities.
- Be able to maintain confidentiality.
- Have strong written and verbal communication skills.
- Preferred: experience in APR DRG coding or auditing.
- Preferred: experience in financial recovery.
Responsibilities
- Review inpatient hospital claims for proper reimbursement.
- Handle provider disputes in a result-oriented, metrics-driven environment.
- Extract clinical information from medical records and assign appropriate medical codes.
- Ensure accurate provider contract payments and correct claims payment.
- Ensure appropriate diagnosis related group (DRG) assignments.
- Analyze, enter, and manipulate database information.
- Respond to or clarify internal requests for medical information.
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