Nurse Auditor

Use your skills to make an impact : Active RN license Experience with outpatient CPT/HCPCS codes Experience with review of medical records 2+ years clinical experience 3+ years' experience in the health industry Preferred Qualifications: Certified Professional Coder (CPC) Familiar with lab or genetic testing Fraud, Waste, and Abuse Investigative experience. Clinical auditing experience Bachelor's degree Familiarity with CMS and Humana regulatory policies Knowledge of general lab billing Additional Information WORK STYLE: Remote/work at home. WORK HOURS: Business hours are Monday-Friday, expected to work 8 hours/day, 5 days/week HireVue: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Work at Home: To Ensure Home Or Hybrid Home/Office Employees' Ability To Work Effectively, The Self-provided Internet Service Of Home Or Hybrid Home/Office Employees 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 employees 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.

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