CPT / HCPCS

coding guidelines and payer-specific rules + Analyze how codes impact reimbursement ( APC grouping, edits, bundling) + Conduct detailed record to bill reviews + Validate appropriate code assignment and modifier usage + Document findings and support defensible audit determinations + Provide recommendations for recovery or education + Partner with clinical and analytics teams on audit strategies Use your skills to make an impact Required Qualifications + CPC , COC , CCS , ROCC , RHIA , or RHIT Certification + 5+ years post certification experience with Outpatient Specialty Surgeries and Procedures + Knowledge of

CPT / HCPCS

coding + Audit experience + Experience reading and coding from operative reports Preferred Qualifications + 5+ years prior coding experience + Outpatient facility auditing experience + Experience with outpatient data trends + Ambulatory Payment Classification ( APC ) coding experience + Experience in prospective payment methodologies + 3M Coding software experience + Radiation Oncology coding experience Additional Information Work at

Home Requirements:

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member

PHI / HIPAA

information.

Travel:

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. 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