Remote Medical Coding Auditor: CPT/HCPCS Expert

DaMar Staffing; United States; Remote; USD 68,770,000 - 123,213,000; Full time

Job summary

UnitedHealth Group is seeking a Medical Coding Auditor to verify claim accuracy against medical records, ensuring compliance with regulations and policies. This role supports complex payment decisions in a telecommuting setup across the U.S.

You will review CPT/HCPCS codes, provide clinical narratives, and maintain high standards for quality, productivity, and compliance while collaborating with other teams.

Qualifications

• AHIMA/ AAPC certified coder (CCA/ CCS/ CCS-P) is required.
• 2+ years of AHIMA or AAPC certified coder experience.
• 2+ years CPT/HCPCS/modifier coding experience.
• 2+ years medical record review experience.
• 1+ year in a metric-driven, daily production environment.
• 1+ year in the health insurance industry with regulatory knowledge.
• 1+ year in Waste & Error principles.

Responsibilities

• Performs clinical review of CPT, HCPCS, and modifiers on claims in a telecommuting environment.
• Determines accuracy of coding and payment recommendations for claims.
• Includes consultations with Medical Director/physicians and policy interpretation.
• Determines appropriate level of service using E/M coding principles.
• Provides detailed clinical narratives on case outcomes.
• Maintains adherence to compliance and reimbursement policies.

Skills

Certified coder

Medical coding experience

Team/metrics driven

Health insurance domain

Waste & Error principles

Written communication

Tools

COSMOS

Facets

CPW

NICE

ISET

UNET

Job description

UnitedHealth Group is seeking a Medical Coding Auditor to verify claim accuracy against medical records, ensuring compliance with regulations and policies. This role supports complex payment decisions in a telecommuting setup across the U.S.

You will review CPT/HCPCS codes, provide clinical narratives, and maintain high standards for quality, productivity, and compliance while collaborating with other teams.