Remote CDI Specialist: DRG & Coding Expert
UnitedHealth Group
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Benefits offered by this job
Job summary
UnitedHealth Group is seeking a seasoned medical coding and DRG specialist to review and validate DRG assignments, applying ICD-10 principles and CMS rules. You will audit medical records, provide expert judgment on reimbursement, and collaborate with Medical Directors to identify and prevent overpayments.
Remote-friendly, full-time role with comprehensive benefits. The position emphasizes complex coding accuracy, financial analysis, and cross-functional collaboration within a leading health
Qualifications
- High School Diploma / GED or equivalent work experience.
- Certified coder with AHIMA or AAPC: RHIA, RHIT, CPC, CIC.
Responsibilities
- Perform DRG validation reviews and confirm DRG assignments.
- Maintain knowledge of ICD-10 coding principles and CMS regulations.
- Review medical records to support coding and reimbursement decisions.
- Act as SME for medical record reviews, quality audits, and coding accuracy assessments.
- Support Payment Integrity initiatives, including cost avoidance development.
- Collaborate with Medical Directors and Utilization Management to identify overpayments.
- Serve as SME for Retrospective Data Mining and Pre-Payment Cost Avoidance.
- Identify trends in provider coding practices and impact opportunities.
Skills
Education
Job description
UnitedHealth Group is seeking a seasoned medical coding and DRG specialist to review and validate DRG assignments, applying ICD-10 principles and CMS rules. You will audit medical records, provide expert judgment on reimbursement, and collaborate with Medical Directors to identify and prevent overpayments.
Remote-friendly, full-time role with comprehensive benefits. The position emphasizes complex coding accuracy, financial analysis, and cross-functional collaboration within a leading health
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