Job Description
Job Listing ID:
4498913 Job Title:
Medical Coding Auditor Evaluation & Management Application Deadline:
Open Until Filled Job Location:
Salem
Date Posted:
05/26/2026 Hours Worked Per Week:
Not Provided Shift:
Not Provided Duration of Job:
Either Full or Part Time, more than 6 months You may contact this employer directly.
(Obtain the contact information to print or add to your jobs.) Job Summary:
Become a part of our caring community The Evaluation & Management Auditor (Medical Coding Auditor) is responsible for the accurate and compliant review of Evaluation and Management services, including complex professional inpatient encounters, minor procedures, emergency room services, consultation services, and annual wellness visits. The ideal candidate will have a strong background in professional fee coding and auditing, expertise in industry-standard encoders, and familiarity with multiple coding resources. This role ensures correct documentation, coding, and billing in accordance with regulatory guidelines, payer policies, and Humana's internal standards. The Medical Coding Auditor Evaluation & Management will report to the Manager, Medical Coding. WORK STYLE
Remote/Work at home WORK HOURS
Associates will work on EST, regardless of where the associate resides. All associates must start between 6AM-9AM EST, Monday - Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Responsibilities:
Conduct comprehensive audits of professional evaluation and management services, inpatient, emergency room, minor procedures, consultation services, and annual wellness service encounters. Review and analyze provider documentation for completeness and accuracy to ensure proper code assignment in accordance with CPT, HCPCS, ICD-10-CM, and CMS guidelines. Utilize various encoders and coding tools/resources (e.g., decisionhealth, 3M, AMA, CMS) to validate code selection and support audit findings. Prepare detailed audit reports, summarizing findings, trends, and recommendations for education or process improvement. Remain current with changes in coding guidelines, payer policies, and industry trends impacting Evaluation & Management services. Assist with internal and external audit responses and appeals as needed. Support compliance initiatives and contribute to ongoing process improvement within the coding and auditing team. Use your skills to make an impact Required Qualifications Current coding certification (e.g., CPC, CCS-P, CPMA, and/or COC). Minimum 3 years of recent experience in professional fee coding and auditing, with demonstrated expertise in inpatient E/M, minor procedures, emergency room, consultation, and annual wellness services. Strong working knowledge of CPT, ICD-10-CM, HCPCS, CMS
guidelines, and payer policies. Proficient in the use of encoders and coding resources (such as 3M, Optum, AAPC, AMA). Excellent analytical, organizational, and communication skills. Ability to work independently and collaboratively in a team environment. Strong attention to detail Preferred Qualifications 5 years post-certification experience auditing professional evaluation & management services - with a strong focus on professional fee inpatient services Experience with electronic health records (EHR) and coding audit software. Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel. Experience in a managed care, payer, or large multi-specialty health system setting. Additional Information WORK STYLE
Remote/Work at home WORK HOURS
Associates will work on EST, regardless of where the associate resides. All associates must start between 6AM-9AM EST, Monday - Friday as a dedicated schedule. Work hours can vary occasionally and/or depending on business needs. Benefits Information:
Humana offers a var... Job Classification:
Medical Records Specialists Access our statewide or regional occupation report for more information about wages,
employment outlooks, skills, training programs, related occupations, and more. Compensation
Salary:
Not Provided Job Requirements
Experience Required:
See Job Summary
Education Required:
None Minimum Age:
N/A Gender:
N/A
