Senior Ambulatory Coder - Edits & Denials (Remote)

Optum; Eden Prairie (MN); Remote; USD 50,000 - 90,000; Full time

Benefits offered by this job

Remote work

Comprehensive benefits package

401k contribution

Job summary

UnitedHealth Group is seeking a Senior Ambulatory Medical Coder Edits to accurately determine CPT and ICD-10 Edits for Professional Services. Remote 40-hour weeks, with shifts across eight hours, and flexibility to telecommute from anywhere in the U.S.

You will provide documentation feedback to physicians and ensure coding aligns with official guidelines, LCD/NCD policies, and payer requirements under the Coding Operations Manager or QM personnel.

Qualifications

• High School Diploma or GED required.
• Professional coder certification with AHIMA and/or AAPC (CCA, CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC, CPC-A) maintained annually.
• 2+ years of Professional/Ambulatory coding experience for all chart types (Surgery, ED, clinics).
• 1+ years of experience with LCD/NCD, Medical Necessity, Modifier Edits, OCE, MUE and NCCI structures.
• 1+ years of experience with coding payer denials.
• Expert proficiency in CPT and ICD-10-CM coding.
• Ability to use a PC in Windows, MS Excel and EMR systems.

Responsibilities

• Identify CPT and ICD-10 Edits for Professional Services following official guidelines.
• Analyze/correct CCI Edits and Medical Necessity accounts.
• Adhere to coding ethics per AAPC/AHIMA.
• Maintain performance standards in coding quality and productivity.
• Provide documentation feedback to providers and query physicians when needed.
• Keep coding knowledge up-to-date via QM/Director communications.
• Participate in coding department meetings and training.
• Handle additional responsibilities as assigned.

Skills

CPT coding

ICD-10-CM

AHIMA/AAPC certification

MS Excel

EMR systems

Medical terminology

Payer denials

CCI Edits

Medical Necessity

Education

High School Diploma/GED

Tools

EPIC

Encoder

Job description

UnitedHealth Group is seeking a Senior Ambulatory Medical Coder Edits to accurately determine CPT and ICD-10 Edits for Professional Services. Remote 40-hour weeks, with shifts across eight hours, and flexibility to telecommute from anywhere in the U.S.

You will provide documentation feedback to physicians and ensure coding aligns with official guidelines, LCD/NCD policies, and payer requirements under the Coding Operations Manager or QM personnel.