Remote Medical Coding Auditor – Claims & Compliance

International Association of Insurance Professionals (IAIP); Northern (KY); Hybrid; USD 68,770,000 - 123,213,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group is seeking a Medical Coding Auditor to verify claims against medical records, ensuring coding accuracy and regulatory compliance. The role requires AHIMA or AAPC certification and at least 2 years of CPT/HCPCS coding and medical record review experience.

You will analyze complex cases, write clinical narratives, and support quality and compliance in a production-driven environment while telecommuting from anywhere in the U.S.

Qualifications

• Certified coder AHIMA (CCA, CCS, CCS-P) or AAPC CPC/CPC-I.
• 2+ years of AHIMA or AAPC certified coder experience.
• 2+ years of CPT/HCPCS/modifier coding experience.
• 2+ years of medical record review experience.
• 1+ year in a metric-driven team with daily production standards.

Responsibilities

• Perform clinical review of CPT, HCPCS, and modifiers on claims in telecommuting setup.
• Determine accuracy of coding/billing and provide payment recommendations.
• Consult with Medical Directors and interpret mandates and policies.
• Apply E/M coding principles to determine appropriate service levels.
• Provide detailed clinical narratives and ensure policy compliance.

Skills

CPT/HCPCS coding

Medical record review

Regulatory knowledge

Data interpretation

Attention to detail

Education

AHIMA/AAPC Certification

Job description

UnitedHealth Group is seeking a Medical Coding Auditor to verify claims against medical records, ensuring coding accuracy and regulatory compliance. The role requires AHIMA or AAPC certification and at least 2 years of CPT/HCPCS coding and medical record review experience.

You will analyze complex cases, write clinical narratives, and support quality and compliance in a production-driven environment while telecommuting from anywhere in the U.S.