Humana Looking For Senior Medical Auditing Professional: REMOTE/WORK AT HOME at Sandy, UT Full Time

The Senior Medical Coding Professional acts as the team SME (Subject Matter Expert) and provides training, guidance, and education for the team.

Extracts clinical information from a variety of medical records and verifies appropriate procedural terminology and medical codes (e.g., ICD-10 CM and PCS) to claims. The Senior Medical Coding Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors and independence.

Responsibilities

The Senior Medical Coding Professional provides guidance and education for the more junior members of the team.

Confirms appropriate diagnosis related group (DRG) assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications

RHIA, RHIT or CCS Certification(s)

3+ years of experience with MS-DRG coding

Comprehensive knowledge of MS Word, Excel and PowerPoint

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Problem solve complex issues

Ability to travel 5% or less of the work year for training, team meetings, possible onsite audits opportunities and implementation needs

Preferred Qualifications

Previous leadership experience

APR coding or auditing experience

Additional Information

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

COVID Vaccination Policy

• For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home.

If progressed to offer, you will be required to:

• Provide proof of full vaccination, including booster, or commit to testing protocols OR
• Provide proof of applicable exemption including any required supporting documentation
• Medical, religious, state and remote-only work exemptions are available.

Hiring Process/Interview Format

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.

Additional Information – How We Value You

• Benefits starting day 1 of employment
• Competitive 401k match
• Generous Paid Time Off accrual
• Tuition Reimbursement
• Parent Leave
• Go365 perks for well-being

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 25m x 10m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves.

The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.

#ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40