Senior Medical Coder

Optum; Eden Prairie (MN); À distance; USD 33 000 - 59 000; Plein temps

Résumé du poste

Optum is seeking a Senior Medical Coder to perform concurrent review of FFS coding within Epic, ensuring CPT and E/M codes are accurately coded for reimbursement. Schedule is Monday–Friday, 8 AM–5 PM, with remote nationwide location.

Responsibilities include applying coding rules, interpreting clinical documentation, querying providers when needed, and mentoring others to improve coding quality. Telecommuting is allowed per policy.

Qualifications

• High School Diploma or GED required.
• AAPC/AHIMA certification (CPC, CPC-H, CPC-P, RHIT, RHIA, CCA, CCS, CCS-P, etc.) preferred.
• 3+ years of coding experience across multiple specialties.
• Strong knowledge of ICD-10-CM, CPT, Modifiers & HCPCS.
• Strong medical terminology and anatomy knowledge.
• Ability to meet deadlines and maintain productivity.
• Telecommuting adheres to UnitedHealth Group policy.

Responsabilités

• Identify appropriate medical codes using medical documentation and reference materials.
• Assign codes for diagnoses, procedures, and services per guidelines.
• Review documentation to ensure accuracy and generate queries when needed.
• Follow up with providers to obtain clarifications and timely responses.
• Use coding software/tools to identify codes and finalize determinations.
• Maintain knowledge of coding guidelines and compliance requirements.
• Educate others to improve coding quality and reduce denials.
• Support audits and respond to coding quality inquiries.
• Navigate clinical software to complete code reviews.
• Perform other duties as assigned.

Connaissances

Medical coding

ICD-10-CM

CPT coding

HCPCS modifiers

Attention to deadlines

Formation

High School Diploma/GED

AAPC/AHIMA certification: CPC/CPC-H/CPC-P/RHIT/RHIA/CCA/CCS/CCS-P

Outils

Epic coding module

Description du poste

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Senior Medical Coder

performs concurrent review of FFS coding rules within Epic, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials.

Schedule: Monday to Friday, 8 AM- 5 PM

Location: Remote - Nationwide

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

• Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines
• Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes
• Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes
• Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information
• Follow up with providers as necessary when responses to queries are not provided in a timely basis
• Utilize medical coding software programs or reference materials to identify appropriate codes
• Apply post-query response to make final determinations
• Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations
• Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters)
• Resolve medical coding edits or denials in relation to code assignment
• Provide information or respond to questions from medical coding quality audits
• Educate and mentor others to improve medical coding quality
• Demonstrate basic knowledge of the impact of coding decisions on revenue cycle
• Attain and/or maintain relevant professional certifications and continuing education seminars as required
• Utilize and navigate across clinical software applications to assign medical codes or complete reviews
• Other duties as assigned

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• High School Diploma/GED
• Coding Certification from AAPC or AHIMA professional coding association: (CPC, CPC-H, CPC-P, RHIT, RHIA, CCA, CCS, CCS-P etc.)
• 3+ years of coding experience including with multiple specialties
• Advance level of knowledge of ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines
• Advance level of knowledge of medical terminology, disease process and anatomy and physiology
• Must be task oriented and able to meet designated deadlines and productivity standards
• All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24.00 to $43.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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