Code Edit Disputes Medical Coder

CarePlus Health Plans Inc

Remote, US
Base: $48,300 - $65,900 py; bonus/equity: not spec...
Hybrid
Code edit disputes
Provider education
Medical record extraction
The Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery

Job Summary

  • The Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery.
  • This role involves extracting clinical information from medical records, assigning appropriate codes (ICD-10-CM, CPT), analyzing databases, and responding to internal requests for medical information.
  • Humana offers competitive benefits that support whole-person well-being, including medical, dental, and vision benefits, a 401(k) retirement savings plan, and various paid time off options.

Matching Summary

The Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery.

Salary

Base: $48,300 - $65,900 per year; Bonus/Equity: Not specified; Benefits: Medical, dental, vision, 401(k), time off, disability, life insurance

Skills & Requirements

Must-have

  • Code edit disputes
  • Provider education
  • Medical record extraction
  • Database analysis
  • Independent initiative and judgment

Nice-to-have

  • Passionate about consumer experiences
  • Continuous improvement focus
  • Production driven environment

Key Requirements

  • AAPC CPC certification (no Apprentice)
  • Minimum 3 years' experience as a Certified Medical Coder
  • Experience with Medicare and Medicaid coding guidelines
  • Strong data entry and attention to detail
  • Intermediate Microsoft Word, Excel, Outlook, and Teams skills

Work Rights

Not specified

Tailored Resume

Cover Letter