We have immediate openings for part-time Certified Medical Coder's with strong experience in multi-specialty outpatient facility and verification of professional charges. Ideal candidates will have experience in Orthopedic, Physician Pain Clinic, Endoscopy, and additional surgery specialty coding. A solid understanding of CPT, ICD-10-CM, HCPCS, and surgical documentations is required. Preference will be given to those with significant surgical coding experience. This position is not coding specialty clinic accounts. Purpose The Medical Coding Specialist plays a key part in ensuring accurate coding for optimal reimbursement and compliance with all coding and billing guidelines. Organizational Structure: The Coding Specialist reports to the Senior Coding Manager. Key Responsibilities: - Accurately review and assign CPT, ICD-10-CM, and HCPCS Level II codes to multi-specialty outpatient surgery and inpatient/outpatient pro fee coding. - Ensure that coding is compliant with federal regulations, payer-specific guidelines, and facility coding policies. Meets productivity standards for position. - Abstract relevant clinical information from surgical notes, operative reports, and related medical documentation. - Work collaboratively with physicians, surgical staff, and billing teams to clarify documentation and ensure coding accuracy. - Utilize coding software, encoder tools, and EHR systems effectively to support accurate and timely charge capture. - Continually enhances coding skills by keeping up-to-date with current coding guidelines and changes in regulations, payer policies, and CMS requirements. Participates in team meetings and educational conferences to ensure coding practice remains current. - Maintains confidentiality and safeguards the privacy of protected health information (PHI). - Conduct periodic audits of coded data to ensure accuracy and identify areas for improvement. - Assist in resolving coding-related denials and contribute to appeal processes when necessary. - Performs other job-related duties as may be assigned or required. Education: High school diploma or GED equivalent. Completion of a formal coding program with the following certification required: Certified Professional Coder (CPC), Certified Coding Specialist - Physician based (CCS-P), or equivalent AAPC or AHIMA approved coding credentials. Candidates with apprenticeship designations in their credentials, regardless of years of experience, will not be considered. Experience: Minimum of three years’ coding work experience encompassing a working knowledge of the ICD and CPT coding systems; medical terminology; anatomy and physiology; and health record content. At least 2 years' specifically in ambulatory surgical service and written and verbal communication skills. Preferred experience to those with familiarity with NCCI edits, modifier usage, and payer-specific rules. Knowledge of reimbursement methodologies (e.g., APC's, fee-for-services) Physical Work Environment: The work environment is a home-based position that involves long periods of sitting with repetitive motions of hand and arm and may include frequent bending and twisting.

Become a part of our caring community and help us put health first The Provider Connectivity Professional 2 provides analysis and support to both internal and external customers on complex EDI-related issues (i.e., electronic exchange of data including enrollment, claims, payments, and clearinghouse activities). The Provider Connectivity Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Where you Come In The Provider Connectivity Professional 2 responds to complex inquiries relating to EDI from providers and internal departments. May help customers with modem set-up, connection protocols. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods and receive guidance where needed. Follow established guidelines/procedures. What Humana Offers We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education. Use your skills to make an impact Required Qualifications – What it takes to Succeed - Strong knowledge of Microsoft products Excel and Access - Minimum of 1 year of experience building reports in SSRS or a similar tool - Ability to identify trends, communicate results, and make recommendations - Excellent organizational skills - Demonstrated verbal and written communication skills - Flexible and ability to adapt to change to support ongoing business needs Preferred Qualifications - Strong knowledge of SQL - PowerPoint, Visio experience - Experience with Availity BI - Experience with querying and extracting data from different data sources to include EDW, SQL, and Access databases - Experience in HIPAA X12 transactions; Claims Submission, Claims Status, Eligibility & Benefits and Referrals & Authorization - SharePoint knowledge - Knowledge of provider office processes and experience working in the provider space Additional Information - How we Value You • Benefits starting day 1 of employment • Competitive 401k match • Generous Paid Time Off accrual • Tuition Reimbursement • Parent Leave Work at Home Requirements • To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: · At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested · Satellite, cellular and microwave connection can be used only if approved by leadership · Associates 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 Interview Format 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. 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. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. 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. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 03-18-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. ​ 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. 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.

Department: 36621 Wake Forest University Health Sciences - Nursing Psychiatric Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Monday - Friday 8:00am -5:00pm Pay Range $20.80 - $31.20 REMOTE Essential Functions - Completes referrals for patients and coordinates with referring and receiving practices and/or departments. - May coordinate and prepare financial estimates for patients. - Obtains all authorizations needed. - Directs patients to providers in their insurance plan. - Reviews benefits and educates patient on insurance coverage. - Coordinates and schedules surgical procedures, diagnostic testing, or other services within various departments with internal and ancillary providers. - Reviews schedules and confirms schedules are accurate and time is properly allocated. - Follows up on all referrals to ensure no care gaps. Physical Requirements Must be able to sit for long periods of time and work in a fast-paced office environment. Should be able to bend and lift up to 10 lbs. Education, Experience and Certifications High School Diploma or GED required. Computer experience required. Thorough understanding of Insurance coverage (FSC/Coverage/Plan types) and Medical Necessity policies preferred. Knowledge of medical records software preferred. Customer service experience required. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation - Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training - Premium pay such as shift, on call, and more based on a teammate's job - Incentive pay for select positions - Opportunity for annual increases based on performance Benefits and more - Paid Time Off programs - Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability - Flexible Spending Accounts for eligible health care and dependent care expenses - Family benefits such as adoption assistance and paid parental leave - Defined contribution retirement plans with employer match and other financial wellness programs - Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

Job DetailsJob Location: Home Office - Oklahoma City, OK 73134Position Type: Full TimeEducation Level: CertificationTravel Percentage: OccasionalJob Shift: DayJob Category: Health Information Management (HIM)JOB PURPOSE: To abstract and code compliantly, accurately and completely as well as group each account to the appropriate DRG to facilitate data quality and ensure accurate and timely reimbursement. Verifies reviews, analyzes, and abstracts medical information; researches missing medical information; assigns accurate codes; appropriately queries physicians when required; elevates documentation issues to management; ensures valid orders are on the record prior to coding; communicates with HIM Director regarding obstacles with orders, charges, physician documentation. Demonstrates proficiency in the coding and grouping of inpatient accounts. ESSENTIAL FUNCTIONS INCLUDE BUT NOT LIMITED TO: Assures data quality by capturing codes and data while complying with NCCI, while maintaining a 95% or higher accuracy rate as validated by audit. Demonstrates consistent and efficient performance by coding a minimum of 3.5 to 4 inpatient accounts per hour. Queries physicians as necessary to clarify missing, ambiguous, incomplete or conflicting documentation in the medical record in order to facilitate complete, accurate and consistent coding. Notifies HIM Director and Manager of Revenue Cycle when the admission order is missing or not signed prior to discharge. Accurately abstracts information from the medical record into the abstracting module. Demonstrates competencies with software systems in use for the HIM coding staff. Collaborates with Director on Coding Queries. Serves as a resource to other coders. Manages time and workload with understanding of the relationship between coding accuracy, timeliness and deadlines. Keeps current of all changes in coding by reading all new Coding Clinics and CPT Assistants annually. Complete a minimum of 10 hours of formal education and 10 hours of informal education (reading coding clinics and CPT Assistant), which can be turned to formal by taking the quiz on the back and submitting for credit. Performs additional responsibility as directed. BEHAVIORAL STANDARDS The individual must support the mission, vision, and goals of Avem Health Partners and serve as a role model within the company. Exhibit positive customer service behavior in every day work interactions. Demonstrate a courteous and respectful attitude to internal workforce and external customers. Communicate accurately and appropriately. Handle difficult situations in a discreet and professional manner. Hold self-accountable for professional practice. Participate in performance improvement activities utilizing principles to support and improve departmental goals. Demonstrate knowledge of unit goals and is active in committees and projects to achieve these goals. Keep current with literature regarding changing practices, interventions and best practices. Assume responsibility for seeking out educational and professional opportunities for personal learning needs and growth as well as meeting mandatory education requirements. Act as a preceptor as requested. Demonstrate excellent work attendance and actively participate in a variety of meetings and training sessions as required. Adhere to the Avem Health Partners Code of Conduct and Standards of Behavior. Complies with established policies and procedures and all health and safety requirements. EDUCATION/QUALIFICATIONS: Graduate of an AHIMA coding program, RHIT or RHIA program. AS or BS degree preferred. Minimum 3-5 years inpatient coding experience preferred or equivalent combination of education and experience. High level of competence in inpatient coding, DRG grouping, ICD-10 diagnostic and procedural code assignment Competency related to coding of outpatient record types. Passing score on company coding test. Possesses basic knowledge of HIM principles and department functions. Possesses advanced knowledge of ICD—10CM and ICD-10PCS coding rules and conventions. Possesses advanced knowledge of medical terminology, anatomy and physiology, disease processes and pharmacology. Ability to read and analyze all aspects of medical record documentation for accurate and complete coding. Possesses a thorough knowledge of the encoder system. Experienced and highly knowledgeable in the DRG/MSDRG grouping system. Ability to abstract information from the medical record for indices and statistical reports. Excellent PC and software utilization skills. Ability to work independently. CERTIFICATION/LICENSURE: CCS, CPC, RHIT or RHIA credentialed by American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) PHYSICAL REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Such accommodations must be requested by the employee/applicant to be considered. This job requires visual abilities and auditory abilities, must be intact to perform duties. Must be able to perform repetitive tasks/motions. Qualifications