Humana

Nurse Auditor 2


Pay$78400.00 - $107800.00 / year
LocationColumbus/Ohio
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: R-384742
      Employer Industry: Healthcare Services

      Why consider this job opportunity:
      - Salary up to $107,800 per year
      - Eligible for a bonus incentive plan based on company and individual performance
      - Comprehensive benefits package including medical, dental, and vision coverage, 401(k) retirement savings plan, and paid time off
      - Remote work opportunity with occasional travel for training or meetings
      - Supportive environment focused on personal wellness and professional growth

      What to Expect (Job Responsibilities):
      - Perform clinical audit and validation processes to ensure accuracy in medical record documentation and diagnosis coding
      - Validate and interpret medical documentation to ensure the capture of all relevant coding
      - Conduct clinical validation reviews of inpatient medical records to verify billed diagnoses
      - Make independent decisions regarding work methods and follow established guidelines and procedures
      - Manage workload independently while ensuring compliance with organizational strategies

      What is Required (Qualifications):
      - Active Registered Nurse (RN) license in the state of residence
      - Minimum of 2 consecutive years of acute inpatient hospital care experience in critical or intensive care settings within the last 5 years
      - In-depth knowledge of complex medical diagnoses including Sepsis, Pneumonia, and Renal Failure
      - Advanced proficiency in MS Office (Word, Excel, etc.)
      - Excellent written, interpersonal, and communication skills

      How to Stand Out (Preferred Qualifications):
      - Bachelor’s Degree in a relevant field
      - Inpatient coding certification (AHIMA or AAPC)
      - Experience in inpatient coding claims
      - Knowledge of prospective payment methodologies and DRG auditing
      - Clinical documentation improvement knowledge (CDE, CDEI certification)

      #HealthcareServices #NurseAuditor #RemoteWork #CareerOpportunity #CompetitivePay

      We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

      Humana looks at every facet of your life and works with you to create a path to health that fits your unique needs

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