Senior Inpatient Medical Coder – Acute Edits & Denials

UnitedHealth Group•Eden Prairie, MN

7d•$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 a Senior Inpatient Medical Coder/Acute Edits and Denials Claims Analyst, you will work remotely to correct, CCI, Medically Unlikely (MUE) Edits, and Medical Necessity Edits in addition to periodic coding. You will also work combine 3 day payment window, denial claim edit, dental and various other WQ accounts. You will ensure that all Inpatient acute hospital 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 querying physicians for documentation under the direction of the Coding Operations Manager or Quality Management personnel. Experience with the following acute inpatient hospital coding elements is required: MS- DRG and APR DRG (severity and risk of mortality) assignment, complication and comorbidity secondary diagnosis code identification, present on admission indicators, ICD-10-PCS procedure code assignment. Experience with charge, supply codes, EPIC Account Activities functions and payer billing workflows is beneficial but not required (these will be trained). You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Requirements

Associate’s degree
Coder certification with credentialing from AHIMA and/or AAPC (RHIA, RHIT, CCS, CIC) upon hire, and to be maintained annually
Certified Coding Specialist - American Health Information Management Association (AHIMA)
CIC Certified Inpatient Coder from American Academy of Professional Coders (AAPC)
Registered Health Information Technician - American Health Information Management Association (AHIMA)
Registered Health Information Admin - American Health Information Management Association (AHIMA)
2+ years of Coding experience
2+ years of Acute Care inpatient medical coding experience (hospital, facility, etc.)
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Nice To Haves

Experience with charge, supply codes, EPIC Account Activities functions and payer billing workflows

Responsibilities

Work acute inpatient hospital claim edits, denials, 3-day rule combines and other secondary work queues for Allina Health.
Recode medical records to satisfy the claims, edits, and denials using coding classifications to ensure data integrity and proper assignments.
Analyze medical records to ensure accurate coding, and send provider feedback to improve the quality of documentation to support code assignment and billing.
Collect and abstract data elements.
Assist customers to address complex issues related to unbilled and incomplete records.
Identify and suggest areas of improvement in high compliance risk coding areas.
Combine accounts; identify codes that require charge build, collaborate with other departments on charging and documentation requirements, participate in special projects involving payer and compliance reviews.
Other duties as assigned.