Remote Medical Coder – CPC/CCS-P Certified

Sacbar; Chelmsford (MA); On-site; USD 33,000 - 59,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401k contribution

Job summary

Optum is a global health services company seeking a certified medical coder to join our Revenue Operations team. This role focuses on coding accuracy across CPT, HCPCS and ICD-10 for diverse care settings, transmitting electronic and paper claims, and coordinating with auditors and payers.

We require 2+ years of coding experience, CPC/CCS/ CCS-H credentials, and strong attention to detail. Telecommuting is allowed from anywhere in the United States, with a comprehensive benefits package and 401k.

Qualifications

• High School Diploma/GED or equivalent experience.
• Certified Coder: CPC, CCS-P, CCS, CPC-H.
• Medical terminology certificate or demonstrated knowledge.
• 2+ years of coding work experience.
• 6+ months of experience and proficiency in current billing software.
• ICD-10, CPT and HCPCS knowledge or related coursework.
• Understanding of third-party billing.
• Ability to work independently and as part of a team.
• Professional, courteous interaction with physicians/providers and staff.
• Excellent organizational and communication skills.

Responsibilities

• Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other providers of professional billing.
• Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
• Contacts providers or their representatives regarding inappropriate, incomplete or unclear coding.
• Search for information in cases where the coding is complex or unusual. Forward unresolved coding questions to manager for review and comment.
• Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations.
• Works directly with the auditors on coding documentation errors and payor updates. Communicates back to the team when appropriate.
• Works with manager on workload to ensure month end completion and accuracy.
• Follows up on outstanding coding related receivables following standard Revenue Operations policy/procedure/process and based upon payer filing deadlines.
• Initiate refunds when appropriate for all third-party insurance receipts in accordance with governmental and insurance contract agreements.
• Ensures appropriateness of payer rejections and denials for coding related reasons.
• Contacts payers/governmental agencies regarding coding related denials and appeals as appropriate following established Revenue Operations policy/procedure/process.
• Notify manager of any coding denial trends
• Responds to coding related inquiries from providers and support staff and others as requested
• Must keep current of governmental and other payor coding and reimbursement rules and requirements
• Maintains productivity, quality standards and processing timelines as established by Revenue Operations Metrics
• Ensures compliance with payer filing deadlines
• Cooperates fully with all governmental and third-party insurer audits
• Adheres to all governmental and third-party compliance issues as directed
• Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
• Complies with established departmental policies, procedures, and objectives
• Enhance professional growth and development through educational programs, webinars, etc.
• Performs other similar and related duties as required or directed
• Regular, reliable and predicable attendance is required

Education

Medical coding certifications (CPC, CCS-P, CCS, CPC-H)

Job description

Optum is a global health services company seeking a certified medical coder to join our Revenue Operations team. This role focuses on coding accuracy across CPT, HCPCS and ICD-10 for diverse care settings, transmitting electronic and paper claims, and coordinating with auditors and payers.

We require 2+ years of coding experience, CPC/CCS/ CCS-H credentials, and strong attention to detail. Telecommuting is allowed from anywhere in the United States, with a comprehensive benefits package and 401k.