Senior Ambulatory Medical Coder Edits

UnitedHealth Group•Eden Prairie, MN

2d•$24 - $43•Remote

About The Position

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. As an Senior Ambulatory Medical Coder Edits you will work remotely to accurately determine CPT and ICD-10 Edits for all types of Professional Coding Services. You will ensure that all coding assignments are accurate according to coding policies and based on the documentation provided in the medical record. Using a thorough knowledge of coding policies and procedures as well as medical terminology and technology, you will be responsible for providing documentation feedback to physicians under the direction of the Coding Operations Manager or Quality Management personnel. This position is full-time (40 hours/week) Monday-Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. 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.

Requirements

High School Diploma/GED (or higher)
Professional coder certification with credentialing from AHIMA and/or AAPC (CCA, CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC, and CPC-A) to be maintained annually
2+ years of Professional/Ambulatory coding experience for all chart types, Same Day Surgery, Observation, Emergency Department, Ancillary services, and Clinics
1+ years of experience working with LCD, NCD, Medical Necessity, Modifier Edits, OCE, MUE and NCCI classification and reimbursement structures
1+ years of experience working with coding payer denials
Expert level of proficiency in CPT and ICD-10-CM coding
Ability to use a PC in a Windows environment, including MS Excel and EMR systems
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Ability to keep all company sensitive documents secure (if applicable)
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Nice To Haves

Experience with various encoder systems (Encoder, EPIC)

Responsibilities

Identify appropriate assignments of CPT and ICD-10 Edits for Professional Services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity accounts
Adhere to the ethical standards of coding as established by AAPC and/or AHIMA
Adhere to and maintain required levels of performance in both coding quality and productivity as established by Optum360
Provide documentation feedback to providers, as needed, and query physicians when appropriate
Maintain up-to-date coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, among others
Participate in coding department meetings and educational events
Additional responsibilities as identified by manager