Remote Prepay Coding Investigator - Fraud

Sustainable World, Inc.; Plymouth, Northern (MN, KY); Hybrid; USD 68,770,000 - 123,213,000; Full time

Benefits offered by this job

Equity stock purchase

401k contribution

Health benefits

Telecommute policy

Job summary

UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and abuse, using CPT coding knowledge to document findings. The role mentors others, handles internal/external projects, and ensures regulatory compliance while supporting client requests.

You’ll be able to telecommute from anywhere in the U.S. and contribute to performance metrics, with pay based on experience and certifications. Benefits include health, incentive programs, and 401k.

Qualifications

• CPT coding experience with CPC or CCS credentials.
• 3+ years of CPT coding experience.
• Must be able to work 8:00am–5:00pm with possible overtime.

Responsibilities

• Review prepay claims with medical records for payment accuracy.
• Review policies, CPT guidelines, and contracts for clinical review.
• Mentor and provide feedback to team on difficult issues.
• Coordinate with internal and external stakeholders to meet client requests.

Skills

CPT coding

Auditing

Healthcare billing

Communication skills

Teamwork

Education

AAPC CPC

AHIMA CCS/RHIT/RHIA

Tools

PC software

Job description

UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and abuse, using CPT coding knowledge to document findings. The role mentors others, handles internal/external projects, and ensures regulatory compliance while supporting client requests.

You’ll be able to telecommute from anywhere in the U.S. and contribute to performance metrics, with pay based on experience and certifications. Benefits include health, incentive programs, and 401k.