Remote CPT Coding Investigator – Prepay Claims

UnitedHealth Group; Plymouth (MN); On-site; Confidential; Full time

Benefits offered by this job

Telecommuting

Job summary

UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud, audit CPT coding, and provide guidance to investigators. The role supports internal and external projects, mentoring colleagues, and ensuring regulatory compliance.

The position offers telecommuting from anywhere in the U.S. and requires a CPC/CCS/RHIT/RHIA or equivalent certification with 3+ years of CPT coding experience.

Qualifications

• High School Diploma or GED required.
• Certification as CPC or CCS, RHIT, or RHIA preferred.
• 3+ years CPT coding experience required.
• Recent coding/auditing experience within last 1–2 years.
• Proficient with PC-based software and health IT tools.
• Able to work 8:00am–5:00pm, Monday–Friday; overtime or weekends may be necessary.
• Must be 18 years of age or older.

Responsibilities

• Review prepay claims with medical records to determine payment accuracy (70%).
• Review CPT guidelines, policies, and contracts relevant to clinical review (10%).
• Participate in client regulatory meetings (5%).
• Assist providers, advocates, and legal teams on complex issues (5%).
• Support additional projects; analyze data; liaise with stakeholders (5%).
• Monitor claim inventory to meet performance guarantees (5%).

Skills

CPT coding

Communication

Team collaboration

Time management

Attention to detail

Education

High School Diploma/GED

AAPC CPC or AHIMA CCS, RHIT, RHIA

Tools

PC-based software

Job description

UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud, audit CPT coding, and provide guidance to investigators. The role supports internal and external projects, mentoring colleagues, and ensuring regulatory compliance.

The position offers telecommuting from anywhere in the U.S. and requires a CPC/CCS/RHIT/RHIA or equivalent certification with 3+ years of CPT coding experience.