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Humana

Medical Coding Coordinator

Remote

Description

The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical records to determine if the appropriate documentation supports billing.

Responsibilities

Medical Coding Coordinator 2

Responsibilities:

  • Process high volume of claims specific to Code Editing
  • Review and respond to disputes based on Code Editing Denials/Reductions
  • Testing on new and existing platforms
  • Flexibility to cross-train within the team
  • Daily reporting
  • Work assigned projects
  • Monitor coding changes to ensure the most current information is available
  • Other duties as assigned

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Required Qualifications

  • Certified Professional Coder certification (CPC)
  • 2 or more years of experience in making claim decisions based on coding knowledge
  • Proficient in Microsoft Office Excel and Word.

Preferred Qualifications

  • 2 years of claims processing experience.
  • Experience working remotely and attending virtual training.
  • Medicare guidelines experience.
  • Experience in a production driven environment.

Additional Information

  • Work Days/Hours: Monday - Friday 8 hour shift -6:00am - 5:00pm Eastern Standard Time (EST) with occasional overtime based on claim volume once trained.

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
  • Satellite, cellular and microwave connection can be used only if approved by leadership
  • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.

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Scheduled Weekly Hours

40

Job ID: humana-R-304801
Employment Type: Other

This job is no longer available.

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