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Health Care in Sterrett,Alabama
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Medical Coding Auditor-WAH in US

Humana Birmingham Full-Time
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The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. 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 is specific to Ambulatory Payment Classification (APC) to identify, collect, assess, monitor and document claims and encounter coding information. Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis and procedure codes based on services rendered. In this role you will:

  • Review medical record information to identify all appropriate coding specific to Ambulatory Payment Classification (APC)
  • Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
  • Support and participate in process and quality improvement initiatives

Required Qualifications

  • High school diploma or equivalent
  • Certified Medical Coder with at least one of the following credentials: CPC, CCS, ROCC, RCC, CPMA, CHCA, RHIA, RHIT
  • Strong knowledge of CPT/HCPS coding
  • Must have minimum of 3 years prior coding experience 
  • Outpatient auditing experience
  • Experience reading & coding from operative reports
  • Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information
  • Ability to work independently and manage work load
  • Comfortable working in a production based work environment
  • Knowledge and experience in the health care environment/managed care
  • Strong written and verbal communication skills; strong analytical, organizational and time management skills
  • Strong knowledge of Microsoft Office products (Word, Excel)

Preferred Qualifications

  • 5+ years prior coding experience as a certified coder
  • Ambulatory Payment Classification (APC)
  • Proven proficiency across a wide range of services, which include evaluation and management, anesthesia, surgical services, radiology and medicine
  • Chemotherapy Infusion experience / Radiation Oncology coding experience
  • Knowledge of Microsoft Access
  • Experience in prospective payment methodologies
  • Strong knowledge of ICD-10 coding
  • 3M Coder/EncoderPro experience

Additional Information

Interview Format 

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours


Skills required

Medical Management
Managed Care
Medical Necessity
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