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 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.

The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in maintaining coding accuracy and supporting revenue cycle integrity.

Schedule:

Monday to Friday, 6 AM- 11 PM, any time zone, 40 hours/week

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 (or higher)

* 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 in a healthcare setting (payer, provider, or health system

* Intermediate level of experience with revenue cycle including coding related denial processing

* Intermediate level of knowledge of ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines

* Intermediate 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:

* Extensive experience in multi-specialty medicine coding, with proficiency in family medicine, internal medicine and pediatrics

* All Telecommuters will be required to adhere to United Health Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work…