CPCs Working for Insurance Companies

Bradenton, FL
Best answers

I am intersted in networking with any licensed professionals that are currently employed by an insurance company.

I would be interested in requesting the AAPC add a forum area dedicated to these folks.

They are definately fulfilling a challenging role and have very unique nuances associated with their daily grind.

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Emily Ludwig, CPC-A

I am currently working for Humana as a Medical Coding Analyst. I do record reviews for all Humana/Medicare members to verify correct diagnostic coding. We compare the diagnoses on medical records to what is submitted on claims by providers. It is both rewarding, and challenging. I absolutely love my job and would recommend my fellow coders to look into similar positions :) A forum is a great idea!
Hi Emily,

It is encouraging to see as a CPC-A you have found a job and one you love. I am seeing in my local chapter a number of CPC-A's that can't find work. This a great avenue to explore.

I have been in the field for 15 years and have always worked on the provider side of things in a number of coding & compliance areas. I have just recently started working for a healthcare cost management company that works for hundreds of TPAs. I am auditing all levels of appeals as well as working on fraud and abuse cases. I absolutely love it and in my whole career have never felt the professional satisfaction that comes with this position.

I do still love to work with providers and am always trying to assist where I can for them.

Adding this angle to my experience has provided invaluable insight that was always a mystery until I started working for this company.

Having a forum dedicated to this area of coding can provide invaluable insight to those working for providers.

Maybe we can get a number of us to request the AAPC add a forum dedicated to our area of the field.
I found my position with Humana on Monster.com. I applied at numerous physician offices, etc. because I never was aware of Insurance companies having coders. Once I saw this on Monster.com I applied. It is a whole new side to coding and it makes it more interesting.
As far as finding these positions, I would just go to different Insurance companies websites and search through career opportunities, or you can try a site such as Monster. It appears that most of them are starting to do medical chart reviews so hopefully more of these positions are coming available.
It really is a great opportunity, and Humana is a great place to work. I am eventually going to be working from home also, which is another great perk for coders! I used to go to different providers in my area and do the chart review on site. Now Humana has hired Record Retrieval Specialists to go and retrieve 100% of records and upload them,then I review them when they are uploaded to our system.
Coders in Insurance Companies

I am a CCS-P and found work in an insurance company after over 20 years on the physician practice side. It is a completely new world for me. I am learning so much. I am in an analyst role and I am enjoying it. A forum would be great to network with others in similar roles to bounce ideas and questions around.
Good Morning,

I just wanted to let you know that I submitted a request through the AAPC's customer service area asking if they would consider adding a a discussion forum dedicated to this area of the field.

I will keep you all posted of any progress.

Have a good Friday!
If this ever goes live, I would be interested as well. I work for Humana though not in a role directly related to coding. I took the CPC course offered through Humana to help me in my functional area (building medical plans on a claims platform).