Senior Medical Coder

Rhode Island Bar Assn.; Washington (Washington County); On-site; USD 33,000 - 59,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Job summary

Optum is seeking a Senior Medical Coder to perform concurrent review of FFS coding rules within Epic, ensuring CPT and E/M codes are accurately coded for maximum reimbursement and minimal denials. Location is remote nationwide with a standard 8–5 schedule.

Responsibilities include applying ICD-10-CM, CPT, HCPCS knowledge; generating documentation queries; mentoring others; and supporting revenue-cycle improvements. Epic experience preferred and telecommuter policy applies.

Qualifications

• 3+ years of coding experience required.
• Advanced knowledge of ICD-10-CM, CPT, modifiers and HCPCS.
• Strong medical terminology and anatomy/physiology knowledge.

Responsibilities

• Apply understanding of relevant medical coding subject areas 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 productivity and turnaround times.
• 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.

Skills

3+ years coding experience

ICD-10-CM CPT HCPCS knowledge

Medical terminology anatomy physiology

Task oriented deadlines

Education

High School Diploma/GED

AAPC/AHIMA coding certification

Tools

Epic

Job description

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.

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

• 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.

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 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.

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.

#RPO, #GREEN