Payment Integrity Coding Professional

CarePlus Health Plans Inc

Remote
Base: $65,000 - $88,600 py; bonus/equity: eligible...
Hybrid
Utilizing code editing guidelines
Data anomalies
In-depth research
The Payment Integrity Coding Professional contributes to overall cost reduction by utilizing code editing guidelines and data anomalies to ensure correct claim payment

Job Summary

  • The Payment Integrity Coding Professional contributes to overall cost reduction by utilizing code editing guidelines and data anomalies to ensure correct claim payment.
  • The role involves in-depth research, cross departmental collaboration, independent determination of the appropriate course of action, and monitoring operational processes.
  • Humana offers competitive benefits that support whole-person well-being, including medical, dental, vision, 401(k), and various paid time off options.

Matching Summary

The Payment Integrity Coding Professional contributes to overall cost reduction by utilizing code editing guidelines and data anomalies to ensure correct claim payment.

Salary

Base: $65,000 - $88,600 per year; Bonus/Equity: eligible for bonus incentive plan; Benefits: medical, dental, vision, 401(k), time off, disability, life insurance

Skills & Requirements

Must-have

  • utilizing code editing guidelines
  • data anomalies
  • in-depth research
  • cross departmental collaboration
  • independent determination
  • monitoring operational processes

Nice-to-have

  • passionate about consumer experiences
  • drive innovation
  • effective operations

Key Requirements

  • AAPC or AHIMA Coding Certification
  • Minimum 3 years post certification experience
  • Exceptional understanding of CMS guidelines
  • Working knowledge of Microsoft Office Programs

Work Rights

Not specified

Tailored Resume

Cover Letter