Senior Medical Coder

DaMar Staffing; United States; Remote; USD 33,000 - 59,000; Full time

Job summary

UnitedHealth Group seeks a Senior Medical Coder to perform concurrent review of FFS coding rules within Epic, ensuring CPT and E/M codes are accurately billed for maximum reimbursement. This remote nationwide role follows a 8 AM-5 PM schedule and supports multiple charts while meeting strict turnaround times.

The ideal candidate has a CPC/Coders certification and 3+ years of coding experience with ICD-10-CM, CPT, HCPCS, and anatomy knowledge.

Qualifications

• High School Diploma or GED required.
• Certification from AAPC or AHIMA (CPC, CPC-H, CPC-P, RHIT, RHIA, CCA, CCS, CCS-P etc.).
• 3+ years of medical coding experience.
• Advanced knowledge of ICD-10-CM, CPT, Modifiers & HCPCS.
• Advanced knowledge of medical terminology and anatomy.

Responsibilities

• Assign appropriate medical codes for diagnoses, procedures and services.
• Interpret clinical documentation and identify applicable codes.
• Generate queries when documentation is unclear or incomplete.
• Follow up with providers to obtain timely responses.
• Use coding software and reference materials to identify codes.
• Apply post-query guidance to finalize determinations.
• Adhere to guidelines to record independent medical code determinations.
• Manage multiple charts while meeting productivity standards.
• Resolve coding edits or denials and respond to quality audits.
• Educate and mentor others to improve coding quality.

Skills

Medical coding

ICD-10-CM

CPT

HCPCS

Epic experience

Education

High School Diploma/GED

Tools

Epic

Coding software

Job description

Senior Medical Coder

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The 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'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• 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
• Other duties as assigned

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
• Advanced level of knowledge of ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines
• Advanced 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

Preferred Qualifications:

• Epic experience

All employees working remotely 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). 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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