Senior Inpatient Edits/Denials
About The Position
Optum360, a partnership between Dignity Health and Optum, provides revenue management services to healthcare providers. The Senior Inpatient Edits/Denials position identifies appropriate inpatient coding and abstraction for facility services, following official and client-specific coding guidelines. The role requires expert knowledge of inpatient DRG coding and maintaining established quality and productivity standards. This is a full-time position of 40 hours per week, Monday through Friday during normal business hours. Occasional overtime may be necessary based on business needs. The position is eligible for telecommuting from anywhere in the U.S., subject to the stated home-workspace, privacy, and internet requirements.
Requirements
- High school diploma or GED.
- Professional coder certification from AHIMA and/or AAPC, such as CCA, CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, or CPC; certification must be maintained annually.
- At least 3 years of experience with inpatient edits/denials coding in an acute care facility setting.
- At least 3 years of experience with ICD-10-CM, ICD-10-PCS, and DRG coding using an encoder.
- Intermediate proficiency using a PC in a Windows environment, including creating and editing Microsoft Excel spreadsheets and working with various EMR systems.
- A dedicated work area separated from other living areas that provides information privacy.
- Ability to keep company-sensitive documents secure, if applicable.
- Residence in a location with a UnitedHealth Group-approved high-speed internet connection, or access to an existing high-speed internet service.
- Adherence to UnitedHealth Group’s Telecommuter Policy.
- Must pass a drug test before beginning employment.
Nice To Haves
- Ability to work at least one weekend day, holidays, and overtime when there is a business need.
Responsibilities
- Assign ICD-10-CM, ICD-10-PCS, DRG codes, and abstractions for facility services according to official coding guidelines and the assigned facility's client coding guidelines.
- Abstract additional data elements during chart review when needed.
- Follow coding ethical standards established by AAPC and/or AHIMA.
- Meet required coding quality and productivity levels established by Optum.
- Query physicians when appropriate.
- Maintain up-to-date coding knowledge by reviewing materials disseminated or recommended by coding and quality management leadership.
- Participate in coding department meetings and educational events.
- Perform additional responsibilities as identified by the manager.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase.
- 401(k) contribution, subject to eligibility requirements.
- Career development opportunities.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
