Remote Medical Coding Auditor for Precise Claims Review

UnitedHealth Group; Plymouth (MN); Remote; USD 33,000 - 59,000; Full time

Benefits offered by this job

Telecommuting

Job summary

UnitedHealth Group is seeking a Medical Coding Auditor to verify claims against medical records, ensuring coding accuracy and compliance across the U.S. This remote role requires independent, judgment-based reviews and collaboration with medical directors and internal teams.

You will analyze CPT/HCPCS coding, maintain production standards, and produce detailed narratives while upholding state and federal guidelines.

Qualifications

• Certified coder AHIMA (CCA, CCS, CCS-P) or AAPC Certified coder (CPC, CPC-I)
• 2+ years of AHIMA or AAPC Certified coder experience
• 2+ years CPT/HCPCS/Modifiers coding experience
• 2+ years of medical record review experience
• 1+ year in a metric-driven, production-focused team environment

Responsibilities

• Performs clinical review of CPT, HCPCS, and modifiers on claims in a telecommuting environment
• Determines accuracy of medical coding/billing and payment recommendations
• Consults with Medical Director/physician as needed and interprets state/federal mandates and policies
• Determines appropriate level of service using E/M coding principles
• Provides detailed clinical narratives on case outcomes
• Ensures adherence to compliance and reimbursement policies
• Identifies aberrant billing patterns and flags for review
• Manages daily case assignments with quality and productivity standards
• Provides clinical support to other investigative and analytical areas
• Participates in department meetings and collaborates with partners
• Works independently and with teams to obtain additional information for reviews

Skills

Certified coder AHIMA

CPT/HCPCS coding

Medical record review

Team collaboration

Attention to detail

Tools

COSMOS

Facets

CPW

NICE

ISET

UNET

Job description

UnitedHealth Group is seeking a Medical Coding Auditor to verify claims against medical records, ensuring coding accuracy and compliance across the U.S. This remote role requires independent, judgment-based reviews and collaboration with medical directors and internal teams.

You will analyze CPT/HCPCS coding, maintain production standards, and produce detailed narratives while upholding state and federal guidelines.