Senior Medical Coder

UnitedHealth Group•Worcester, MA

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. You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Requirements

High School Diploma/GED
Certified Coder – Billing and Coding preferred, Certified or Eligible for certification: CPC, CCS
3+ years of medical coding experience
Medical terminology certificate or demonstrated knowledge
Demonstrated knowledge and experience in ICD10, CPT and HCPCS coding or successful completion of related college course

Nice To Haves

Leadership experience
Demonstrated knowledge of third- party billing
Excellent organizational and communication skills.
3-5 years of work experience
Ability to work independently and as part of a team
Must demonstrate a professional and courteous manner when interacting with physicians/providers, clinical department staff and co-workers

Responsibilities

Oversees surgical coding team of 8 coders. Facilities and monitors workflows. Assigns work daily and projects as needed
Responsible for procedure and diagnostic coding of professional charges. Works closely with clinical department physicians and staff to ensure accurate and compliant coding and maximization of revenue through initial coding and appeals of payer rejections relating to coding
Proves complex coding expertise in all functions of day to day processes, including Epic proficiency, exceptional communication both verbal and written and outstanding quality of work
Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other providers of professional billing
Contacts providers or their representatives regarding inappropriate, incomplete or unclear coding
Search for information in cases where the coding is complex or unusual. Forward unresolved coding questions to manager for review and comment
Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations
Works directly with the auditors on coding documentation errors and payor updates. Communicates back to the team
Works with team on workload to ensure month end completion and accuracy
Follows up on outstanding coding related receivables following standard Revenue Operations policy/procedure/process and based upon payer filing deadlines
Updates team on change to policies and coding changes
Reviews coding denial reports with management
Responds to coding related inquiries from providers and support staff and others as requested
Must keep current of governmental and other payor coding and reimbursement rules and requirements
Reports accurate productivity and other data as requested
Maintains productivity, quality standards and processing timelines as established by Revenue Operations Metrics
Ensures compliance with payer filing deadlines
Adheres to all governmental and third -party compliance issues as directed
Complies with established departmental policies, procedures, and objectives
Performs other similar and related duties as required or directed
Regular, reliable and predicable attendance is required