Senior IP Acute Edits Medical Coder

UnitedHealth Group • Eden Prairie, MN

114d • $23 - $41

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member-centric approach to care. As a Certified Sr. (IP) Acute Edits Medical Coder you will determine and record the correct medical codes for all treatments and health services. Ensuring proper records is just one way your work will impact on the health and wellness of our members on a huge scale.

Requirements

• High School Diploma/GED (or higher)
• Professional coder certification with credentialing from AHIMA and/or AAPC (CCS, RHIA, RHIT, CIC, ROCC, CPC, COC, CPC-P) to be maintained annually
• 3+ years of recent inpatient medical coding experience with ICD-10-CM/PCS & DRG (hospital, facility, etc.)
• 2+ years of recent working experience with OCE, MUE and NCCI classification and reimbursement structures
• Intermediate level of proficiency with a PC in a Windows environment, including MS Excel and EMR systems
• Intermediate level of experience working in a level I trauma center and/or teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding

Nice To Haves

• Experience with OSHPD reporting
• Experience with various encoder systems (eCAC,3M, EPIC)
• Intermediate level of proficiency with Microsoft Excel

Responsibilities

• Identify appropriate assignment of ICD-10-CM and ICD-10-PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC/MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Identify appropriate assignments of CPT and ICD-10 Codes for outpatient surgery, observation, emergency, and ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Understand the Medicare Ambulatory Payment Classification (APC) codes
• Abstract additional data elements during the Chart Review process when coding, as needed
• 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 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, etc.
• Participate in coding department meetings and educational events
• Review and maintain a record of charts coded, held, and/or missing
• Additional responsibilities as identified by manager

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees