Job Details

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 theyneed 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 to identify appropriate medical codes and reference code applicability, rules, and guidelines
• 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 relevant productivity and turnaround time standards for completing medical records
• 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

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 $23.89 to $42.69 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 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.