Nurse Auditor 2 Remote Nationwide

Become a part of our caring community and help us put health first The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and billing for services rendered is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical record documentation to ensure billing for services is complete, accurate and follows all necessary guidelines. Applies clinical experience when conducting chart reviews of hospital and facility billing. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact WORK STYLE: Remote/work at home. While this is a remote position, occasional travel to Humanas offices for training or meetings may be required. WORK HOURS: Typical business hours are Monday-Friday, 5 days/week, 8 hours/day. Some flexibility might be possible, depending on business needs. Associates will work in their own time zone.

Required Qualifications

• Active Registered Nurse (RN) license
• Minimum of 3+ years nursing experience
• Able to apply analytical and critical thinking skills to reviews
• MS Office proficiency
• Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information
• Ability to work independently, manage workload, and work in a production-based environment
• Customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• Excellent writing, editing, interpersonal, planning, teamwork, and communications skills
• Comfortable working in an ever-changing environment

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Preferred Qualifications

• STRONGLY PREFERRED: Previous auditing, Nurse Coder Background, and/or CPT procedural code experience/certified coder (CPC)
• Nursing experience preferred in Acute care, OR, Coding, and/or Quality
• Clinical documentation improvement (CDI) knowledge
• Bachelors Degree in relevant field preferred
• ​Prospective payment methodologies, auditing experience

Additional Information Work at Home Requirements

• 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 Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire 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. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humanas 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. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity i