Profee E/M Medical Coder

Texas Health Institute; Eden Prairie (MN); Hybrid; USD 58,292,000 - 104,415,000; Full time

Job summary

Optum, a part of UnitedHealth Group, is seeking a professional coder for full-time remote work in the U.S. The role involves applying CPT/ICD-10 coding across diverse services, maintaining coding quality, and providing feedback to providers. Requires AHIMA/AAPC credentials and 3+ years of ProFee experience.

The position emphasizes adherence to coding guidelines, collaboration with QA teams, and ongoing professional development within a flexible telecommuting setup.

Qualifications

• AHIMA and/or AAPC (CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC) credentialing maintained annually.
• 3+ years of experience with ICD-10, CPT and HCPCS.
• Ability to use Windows PC, Excel, and multiple EMR systems.

Responsibilities

• Identify assignment of CPT, ICD-10 codes and modifiers for E/M services across multiple departments.
• Expert knowledge in ProFee coding specialties (E/M, Critical Care, Trauma) per guidelines.
• Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits.
• Abstract additional data elements during chart reviews when coding.
• Provide documentation feedback to providers and query physicians when appropriate.
• Maintain up-to-date coding knowledge and participate in coding dept meetings.

Skills

ProFee coding

CPT/HCPCS

EMR systems

Excel

Education

High School Diploma/GED

AHIMA/AAPC certification

Tools

EMR software

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together.

This position is full-time (40 hours/week) Monday-Friday, normal business hours. It may be necessary, given the business need, to work occasional overtime.

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

Primary Responsibilities:

• Identify appropriate assignment of CPT, ICD-10 Codes and Modifiers for various E/M services across multiple services including but not limited to: Emergency Department, Hospitalists, Primary Care, etc
• Expert knowledge in all ProFee coding specialties; including but not limited to, Evaluation & Management, Critical Care, Trauma while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits
• Abstract additional data elements during the chart review process when coding, as needed
• Adhere to the ethical standards of coding as established by AAPC and/or AHIMA
• Adhere to and maintain required levels of performance in both coding quality and productivity as established by Optum
• Provide documentation feedback to providers, as needed, and query physicians when appropriate
• Maintain up-to-date coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, among others
• Participate in coding department meetings and educational events
• Review and maintain a record of charts coded, held, and / or missing
• Additional responsibilities as identified by manager

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 with credentialing from AHIMA and/or AAPC (CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC) to be maintained annually
• 3+ years of experience with ICD-10, CPT and HCPCS
• Ability to use a PC in a Windows environment, including Microsoft Excel (create and edit spreadsheets) and utilize various EMR systems with ease
• Ability to flex and float to multiple clients as directed

Preferred Qualifications:

• 3+ years of Outpatient Professional (ProFee) E/M coding experience
• Ability to work at least one weekend, day, holidays, and overtime when there is a business need

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location where there is 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 $20.38 to $36.44 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

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