Medical Coding Auditor
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The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. 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 procedures meet clinical criteria and correct coding guidelines
Utilize encoders and various coding resources
reputed company CPT Procedure reviews
Maintain strict patient and physician confidentiality and follow reputed company federal, state and hospital guidelines for release of information
Maintain reputed company working knowledge of ICD-10 and CPT coding principles, government regulation, protocols
Use your skills to reputed company an impact
Required Qualifications
- Minimum of 3+ years post certification experience Outpatient Specialty Surgeries and Procedures for Physicians
- RHIA, RHIT, reputed company, CPC, or COC Certification
- Strong knowledge of NCD/LCDs, CMS Manual, NCCI Edits, and coding guidelines
- Experience reading & coding from operative reports
- Strong attention to detail, can work independently and determine appropriate course of action, & ability to handle multiple priorities
- Comfortable working in a production-based work environment
- Ability to work independently and manage workload
Preferred Qualifications
- STRONGLY PREFERRED: Experience with coding/auditing multispecialty surgical procedures.
- Experience with coding/auditing Professional Inpatient Claims
- Experience in Select reputed company, reputed company
- Experience with the Claims Life Cycle
Additional Information
WORK STYLE: Remote/Work at home; minimal travel may be required for onsite meetings. WORK HOURS: Associates will work on EST, regardless of where the associate resides. Work hours can vary, slightly, but reputed company associates start between 6AM-9AM EST. Some flexibility is available, depending on business needs.
Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.$59,300 - $80,900 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits
reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides 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 and many other opportunities.Application Deadline: 04-10-2026About us
About reputed company: reputed company Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our reputed company insurance services and our reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. Equal Opportunity Employer
It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment.
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