Medical Coding Consultant

Description Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.

Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.

Role: Medical Coding Consultant
Assignment: Provider Network Operations
Location: Louisville, KY - Waterside Building

Are you a fit?
Are you ready to take your medical coding knowledge to the next level? Do you like seeing your contribution lead to improvements in consistency?

Assignment Capsule
The Code Edit Consultant provides strategic leadership and consultation while utilizing his/her knowledge to support ongoing maintenance and updating of code editing logic. The Consultant will interact and build partnerships with the Clinical Edit Review Team (a multifunctional team made up of Humana's Medical Directors and leaders from across the organization),Information Technology Team, Product Development as other departments and vendors. A day in the life of a consultant might include, addressing code editing questions, establishing logic for multiple platforms to ensure appropriateness of edits and increase consistency across platforms. Responsibilities include serving as a subject matter expert.

• SME for code editing logic
  
• Act as a liaison between multiple business partners to identify and resolve issues related to code logic
  
• Prepare information for examination by Clinical Edit Review Team.
  
• Work with vendors to retrieve updates on licensed software,
  
• Triage assignments based on urgency; utilize knowledge to ensure escalation when necessary.

Key Competencies

• Builds Trust: You honor your word by doing what you say you are going to do.
  
• Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.
  
• Innovate: You introduce new ideas and processes which improve performance and productivity.
  
• Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.

Role Essentials

• Coding certification (CPC, RHIT, etc.)
  
• Extensive knowledge of multiple types of medical coding, such as ICD, CPT, HCPCS
  
• Strong organization and project management skills including experience managing process
  
• Ability to juggle multiple priorities in a fast paced environment, keeping everyone on target
  
• Ability to work independently

Role Desirables

• Claims processing knowledge
  
• BA or BS, Finance or related fields

Reporting Relationships

• You will report to a Manager. This area is under the direction of the SVP & Chief Operating Officer.

Requirements See Above