Humana09.03.26
AI SCORE 8.5

Clinical Coding Director - Remote Position

$139K–$191K/year

About the Role

Humana is hiring a full-time Clinical Coding Director, Payment Integrity, working remotely from the United States. As a Clinical Coding Director, you will play a crucial role in overseeing the coding processes and ensuring compliance with industry standards. This is an exciting opportunity to lead a dedicated team and make a significant impact in the healthcare sector.

What You'll Do

  • Lead and manage the Clinical Coding team to ensure accurate coding practices and adherence to regulatory guidelines.
  • Develop and implement coding policies and procedures to enhance operational efficiency.
  • Collaborate with cross-functional teams to improve payment integrity and reduce claim denials.
  • Monitor coding quality and provide feedback and training to coding staff.
  • Analyze coding trends and implement strategies to optimize revenue cycle management.

Requirements

  • Minimum of 5 years of experience in clinical coding, with at least 3 years in a leadership role.
  • Strong knowledge of ICD-10, CPT, and HCPCS coding systems.
  • Experience with payment integrity processes and healthcare reimbursement methodologies.
  • Excellent communication and interpersonal skills.
  • Certification in coding (e.g., CPC, CCS) is preferred.

Nice to Have

  • Experience with electronic health record (EHR) systems.
  • Familiarity with data analytics tools for coding performance assessment.

What We Offer

  • Competitive salary range of $138,900 - $191,000.
  • Comprehensive health benefits and wellness programs.
  • Flexible work environment with remote work opportunities.
  • Professional development and training programs.
  • Supportive team culture focused on collaboration and innovation.
Why This Job8.5 of 10

This Clinical Coding Director position at Humana offers a competitive salary and the opportunity to lead a dedicated team in a remote setting, making a significant impact in the healthcare industry.

Salary Range
Required
0/1
Optional
0/1
Bonus
0/1

Who Will Succeed Here

Proficient in ICD-10, CPT, and HCPCS coding systems with a strong understanding of coding compliance and healthcare reimbursement processes, enabling accurate oversight of coding practices.

Self-motivated with excellent remote leadership skills, able to effectively manage a distributed team while fostering a culture of accountability and continuous improvement in a virtual work environment.

Analytical mindset with experience in data analytics to assess coding accuracy and compliance, leveraging data-driven insights to enhance coding processes and address discrepancies.

Learning Resources

ICD-10-CM Coding Guidelinesguide

Career Path

Clinical Coding Director(Now)Senior Director of Coding Compliance(1-2 years)Vice President of Coding and Reimbursement(3-5 years)

Market Overview

Market Size 2024
$10.5B
Annual Growth
7.2%
AI Adoption in Healthcare
34%
Investment in Health IT
+25%
Labour Demand for Clinical Coders
+15%
Avg Salary for Clinical Coding Director
$120K

Skills & Requirements

Required
ICD-10CPTHCPCS
Growing in Demand
Natural Language Processing (NLP)Machine Learning for HealthcareAdvanced Data Analytics
Declining
Manual Coding TechniquesTraditional Medical Billing Software

Domain Trends

Increased Automation in Coding
The integration of AI and automation tools is transforming clinical coding processes, with a projected increase in automation adoption by 40% by 2025.
Shift Towards Value-Based Care
Healthcare providers are increasingly focusing on value-based care models, leading to a 30% rise in demand for coding compliance expertise to ensure accurate reimbursement.
Emphasis on Data Analytics
The use of data analytics in healthcare reimbursement is expected to grow by 50% in the next three years, enhancing the accuracy and efficiency of coding practices.

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