Code Edit Disputes Review Team Medical Coding Coordinator

Greetings prospective candidates!

Are you a detail-oriented individual with a passion for medical coding and a knack for problem-solving? If so, we have an exciting opportunity for you to join our team at Humana as a Code Edit Disputes Review Team Medical Coding Coordinator. In this role, you will play a crucial role in ensuring accurate coding and reimbursement for medical claims by reviewing and resolving code edit disputes. We are seeking someone with strong coding knowledge and experience, as well as excellent communication and organizational skills. If you are ready to take on a challenging and rewarding role in the healthcare industry, we encourage you to apply for this position.

Your Responsibilities

• Review and resolve code edit disputes to ensure accurate coding and reimbursement for medical claims.
• Utilize strong coding knowledge and experience to effectively navigate and resolve coding discrepancies.
• Communicate with internal and external stakeholders to gather necessary information and resolve disputes in a timely manner.
• Identify and escalate any recurring or systemic issues to management for further review and resolution.
• Maintain accurate and detailed documentation of all code edit disputes and resolutions.
• Collaborate with cross-functional teams, including medical coders, claims processors, and providers, to identify and resolve coding issues.
• Stay up-to-date on current coding guidelines and regulations to ensure compliance.
• Act as a subject matter expert for coding guidelines and procedures within the team.
• Assist in training and mentoring new team members on coding processes and procedures.
• Prioritize and manage a high volume of code edit disputes to meet strict deadlines.
• Coordinate with other departments to implement process improvements and streamline workflows.
• Adhere to all confidentiality and HIPAA regulations in handling sensitive information.
• Participate in regular team meetings and provide updates on code edit dispute status and resolution.
• Maintain a positive and professional attitude when communicating with colleagues and stakeholders.
• Continuously seek opportunities for personal and professional development to enhance coding skills and knowledge.

Equal Opportunity Employer Statement

Humana is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.