Registered Nurse Certified Professional Coder

UnitedHealth Group•Tampa, FL

1d•$91,700 - $163,700•Remote

About The Position

This position is for a Certified Coder who will provide coding expertise and clinical support across a wide range of initiatives and processes. This role requires close collaboration with cross-functional teams to ensure alignment with both clinical and business objectives, while supporting the successful execution of projects. As the organization accelerates its digital transformation, Benefit Digitization and AI 10.0 efforts are key to improving efficiency, enhancing member and provider experiences, and managing long term costs. To achieve these goals, dedicated roles are needed to design, implement, and manage the digital capabilities that support these initiatives.

Requirements

High School Diploma/GED or equivalent work experience
Must be 18 years of age or older
Certified Professional Coder (AAPC or AHIMA)
Active unrestricted nursing license
3 + years’ experience with coding and reimbursement methodologies (e.g. CPT, HCPCS, ICD-10, CMS,).
Intermediate proficiency in Microsoft Office applications, including Word (create, edit, format, and manage professional documents), Excel (analyze data, create reports, utilize formulas, pivot tables, and data visualization tools), and PowerPoint (develop professional presentations and effectively communicate information to a variety of audiences)
Ability to work full-time (40 hours/week), Monday – Friday. Employees must work an 8-hour shift during business operating hours of 8:00am-5:00pm EST.
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Ability to analyze and translate data to develop recommendations for action plans
Excellent written and verbal communication skills
Able to work with minimal supervision
Flexible with a strong ability to multitask
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Candidates are required to pass a drug test before beginning employment.

Nice To Haves

Experience working with UnitedHealthcare (UHC) benefit plans, including interpretation and application of member benefits, coverage guidelines, and plan design
Experience in claims, medical policy, benefits/product administration, and/or medical management

Responsibilities

Partner with clinical, operational, and enterprise teams on coding initiatives, including benefit digitization programs, serving as a subject matter expert and providing strategic guidance to support successful implementation.
Develop, implement, and promote standardized coding methodologies to ensure consistent, accurate, and compliant interpretation and digitization of benefit structures across the organization.
Create, maintain, and manage procedure and service code groupings to support accurate benefit alignment and administration.
Maintain coding integrity through governance processes, ongoing quality oversight, and adherence to current industry standards, regulatory requirements, and organizational policies.
Manage quarterly and annual industry-standard code updates, benefit plan changes, and mandate-driven coding enhancements to ensure continued compliance and operational accuracy.
Provide coding support for benefit administration across diverse markets, including the development of customized coding solutions for complex or nonstandard benefit requests.
Serve as the primary resource for coding-related inquiries, delivering clinical expertise, consultation, and guidance to project teams, business partners, and stakeholders.
Collaborate across cross-functional workstreams to identify coding impacts, support business and operational initiatives, and drive effective implementation of coding solutions.
Ensure coding aligns with regulatory mandates and emerging industry requirements, proactively supporting updates and compliance initiatives.
Deliver certified coding expertise and clinical support to meet a broad range of organizational, operational, and strategic business needs.