Senior Medical Coder

UnitedHealth Group•Chelmsford, 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 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. 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 or equivalent experience
Certified Coder: CPC, CCS-P, CCS, CPC-H
Medical terminology certificate or demonstrated knowledge
2+ years of coding work experience
6+ months of experience and proficiency in current billing software
Intermediate level of knowledge and experience in ICD-10, CPT and HCPCS coding or successful completion of related college courses
Demonstrated knowledge of third-party billing
Ability to work independently and as part of a team
Ability to demonstrate a professional and courteous manner when interacting with physicians/providers, clinical department staff and co-workers
Excellent organizational and communication skills
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Responsibilities

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
Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
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 when appropriate
Works with manager 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
Initiate refunds when appropriate for all third-party insurance receipts in accordance with governmental and insurance contract agreements
Ensures appropriateness of payer rejections and denials for coding related reasons
Contacts payers/governmental agencies regarding coding related denials and appeals as appropriate following established Revenue Operations policy/procedure/process
Notify manager of any coding denial trends
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
Maintains productivity, quality standards and processing timelines as established by Revenue Operations Metrics
Ensures compliance with payer filing deadlines
Cooperates fully with all governmental and third-party insurer audits
Adheres to all governmental and third-party compliance issues as directed
Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
Complies with established departmental policies, procedures, and objectives
Enhance professional growth and development through educational programs, webinars, etc.
Performs other similar and related duties as required or directed
Regular, reliable and predicable attendance is required