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HUHumana Inc. is a for-profit American health insurance company based in Louisville, Kentucky, offering a wide range of insurance products and health and wellness services.
The Medical Coding Coordinator 3 performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. This role is responsible for researching, reviewing, and educating providers regarding disputes on adjudicated claims involving code editing denials or recoveries. The coordinator analyzes, enters, and manipulates data within relevant databases, and responds to or clarifies internal requests for medical information.
Decisions in this role typically focus on methods and processes for completing administrative tasks and projects. The Medical Coding Coordinator 3 regularly exercises discretion and judgment in prioritizing requests, interpreting, and adapting procedures, and works under limited guidance, drawing upon extensive knowledge and experience with administrative and organizational processes.
WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's office in San Juan, PR for training or meetings may be required.
WORK HOURS: Typical business hours are Monday-Friday, 8 hours/day and 5 days/week.
**This is a remote position in Puerto Rico** Candidates must reside in Puerto Rico, no more than one hour away from Humana’s headquarters, located at Avenida Luis Muñoz Rivera 383, San Juan, PR 00918.
Must be fluent in English with the ability to speak, read, and write in that language without limitations or assistance. If selected for the position, you will be required to take a Language Proficiency Assessment in English / Spanish (see Language Proficiency Testing below)
Coding Certificationrequired: AAPC CPC (no Apprentice) or AHIMA CCS
Minimum of 3 years' experience as a Certified Medical Coder
Demonstrate ability to problem-solve complex coding issues
Experience with Medicare and Medicaid coding guidelines
Strong data entry and attention to detail skills with the ability to manage multiple tasks in a fast-paced setting with competing priorities
Intermediate experience with Microsoft Word and Excel, Outlook, and Teams
5 or more years of experience as a Certified Medical Coder
MS-DRG auditing or APR auditing experience
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Experience in a production driven environment
Additional Information
Language Proficiency Testing. Must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
**PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) ** PLEASE SUBMIT YOUR RESUME IN ENGLISH
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Full Time
Salary: 36k-49k USD
United States +/- 0 hours, and 1 other timezoneLearn more about Humana and their company culture.
Humana Inc. is dedicated to improving the health and well-being of the millions of people it serves. Our customers often navigate complex healthcare systems and face challenges in accessing affordable, high-quality care. That's why we are committed to putting health first, not just for our members, but also for our teammates and the broader communities we impact. We understand that true health encompasses more than just physical well-being; it includes emotional, social, and financial health. Therefore, we strive to offer personalized care from people who genuinely care, listening to our members' needs and creating solutions that help them achieve their best selves. Our approach is rooted in an integrated care delivery model that aims to simplify the healthcare experience, making it easier for individuals and families to get the right care at the right time.
Since our founding in 1961, initially as a nursing home company and later evolving into a leading health insurance provider, Humana has consistently adapted to meet the changing needs of the healthcare landscape. We specialize in government-sponsored programs, with a significant portion of our medical membership stemming from Medicare Advantage, Medicaid, and TRICARE. Beyond traditional insurance, Humana is increasingly focused on providing comprehensive healthcare services, including primary care, at-home care, and pharmacy benefit management through our CenterWell brand. We recognize that many of our customers, particularly seniors, are managing multiple chronic conditions. Our integrated care delivery model, which leverages both high-tech tools like data analytics and personalized, low-tech interactions such as in-home visits, allows us to predict, slow, and sometimes even prevent disease progression. We are deeply invested in the communities we serve, working to address health disparities and improve local health outcomes through initiatives like our Bold Goal, which aims to improve the health of the communities we serve by making it easier for people to achieve their best health.
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HU5000+ employees
1961
James Rechtin
COUnited States onlyEmployee count: 1001-5000
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