Evaluation and Management Medical Coder/Auditor

Internationalinsuranceprofessionals; Plymouth (MN); Hybrid; USD 57,859,000 - 103,320,000; Full time

Job summary

UnitedHealth Group is seeking an Evaluation & Management Medical Coder to deliver coding and auditing services to providers. The role focuses on translating diagnoses, procedures, and circumstances into accurate codes and educating provider offices.

Work is full-time with CST hours 8:00 AM–4:00 PM and occasional overtime. Telecommute from anywhere in the U.S.; virtual training is provided from home. Competitive benefits and growth opportunities available.

Qualifications

• High School Diploma or GED required.
• Professional coder certification (CPC/COC/CPC-P/CCS) with AHIMA or AAPC credentialing to be maintained annually.
• Experience in medical coding or auditing in the past year is required.
• 2+ years' experience with E/M (Evaluation & Management) medical coding.
• 2+ years interacting with physicians in medical settings.
• 2+ years of high-volume telephonic experience.
• 2+ years working with EMR systems.
• Proficiency with Microsoft Word, Excel, and Outlook.

Responsibilities

• Education outreach to providers via phone and email on coding and documentation guidelines.
• Lead provider education via phone/email with minimal notice.
• Audit outpatient claims to verify services, codes, modifiers, and units; provide written feedback per guidelines.

Skills

Medical coding

Auditing

Provider communication

Telephonic support

EMR systems

Microsoft Word

Microsoft Excel

Microsoft Outlook

Shift flexibility

Customer service

Education

High School Diploma/GED

Professional coder certification (CPC/COC/CPC-P/CCS)

Tools

EMR software

Encoder systems (3M/EPIC/eCAC)

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

As an Evaluation & Management Medical Coder, you will provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. The ideal candidate will possess prior experience of any kind talking to physicians, non - physician providers and / or their staff. Have excellent research skills and be persistent when calling provider offices.

This position is full-time. Employees are required to work our normal business hours of 8:00 AM - 4:00 PM CST. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of paid training. The hours of the training will be based on your schedule during normal business hours or will be discussed on your first day of employment. Training will be conducted virtually from your home.

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

• Responsible for educational outreach via phone and email to providers. Educational outreach involves effectively communicating coding and documentation guidelines, both verbal and written, to provider(s), provider office staff and / or designated biller(s)
• 80-90%: Provider educational outreach via phone/email to communicate the program and coding and documentation guidelines. Be ready to discuss with individuals or groups with minimal notice
• 10-20%: Audit outpatient claims to validate reported services, appropriate use of procedure codes, modifiers, identify potential unbundled services, confirm place of service and number of units per claim line item. Provide written feedback using best practice industry standards and/or health plan guidelines

What are the reasons to consider working for UnitedHealth Group?

Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success.

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life & AD&D Insurance along with Short‑term disability and Long‑Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• High School Diploma/GED
• Professional coder certification (CPC, COC, CPC - P, CCS) with credentialing from AHIMA and / OR AAPC to be maintained annually
• Medical coding or auditing experience in the past year
• 2+ years of experience with E&M (Evaluation & Management) medical coding
• 2+ years of experience interacting with physicians in a medical setting (medical coding, medical billing, OR claims processing)
• 2+ years of high-volume telephonic experience
• 2+ years of experience in working with EMR (Electronic Medical Record)
• Intermediate level of proficiency with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables), and Microsoft Outlook (email and calendar management)
• Ability to work any shift between the hours of 8:00 AM - 4:00 PM CST including the flexibility to work occasional overtime based on business need

Preferred Qualifications

• 2+ years of Outpatient Facility coding experience
• Experience with various encoder systems (eCAC, 3M, EPIC)

Telecommuting Requirements

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high‑speed internet connection or leverage an existing high‑speed internet service

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $36.00 per hour based on full‑time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone‑of every race, gender, sexuality, age, location, and income‑deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO, #GREEN