Senior Medical Coding Professional, Inpatient
Job summary
Work model
Become a part of our caring community
The Senior Medical Coding Professional, Inpatient supports payment integrity initiatives by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity.
Key Responsibilities
- Review inpatient records for coding accuracy and DRG validation
- Identify anomalies for audit targeting
- Apply ICD-10-CM/PCS coding guidelines and DRG logic
- Assess how coding impacts reimbursement and severity adjustment
- Conduct retrospective audits and document findings
- Recommend adjustments, recoveries, or provider education
- Collaborate with clinical reviewers and data analysts
Use your skills to make an impact
Required Qualifications
- Required: RHIA, RHIT, CCS, or CIC
- 5+ years inpatient coding experience
- Audit or validation experience
- Strong DRG knowledge (MS-DRG/APR-DRG)
- Understanding of CDI and severity of illness (SOI/ROM) concepts
Preferred Qualifications
- 3M Coding software experience
- BA degree
- Previous leadership experience
Additional Information
Work-At-Home Requirements
- To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
- Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Our Hiring Process
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. If you are selected, you will receive correspondence inviting you to participate in a HireVue assessment (approx. 10-15 minutes).
#LI-LM1
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan.
Description of Benefits
Humana offers competitive benefits that support whole-person well-being, including medical, dental and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 07-09-2026
About us
Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health.
Equal Opportunity Employer
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.