Senior Medical Coder

UnitedHealth Group•California, MD

10d•Remote

About The Position

The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in maintaining coding accuracy and supporting revenue cycle integrity. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Requirements

High School Diploma/GED
Coding certification from AAPC or AHIMA Professional Coding Association: (CPC, CPC-H, CPC-P, RHIT, RHIA, CCA, CCS, CCS-P etc.)
3+ years of coding experience including with multiple specialties
1+ years family practice experience
Advanced level of knowledge of ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines
Advanced level of knowledge of medical terminology, disease process and anatomy and physiology
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Responsibilities

Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes
Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes
Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information
Follow up with providers as necessary when responses to queries are not provided in a timely basis
Utilize medical coding software programs or reference materials to identify appropriate codes
Apply post-query response to make final determinations
Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations
Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters)
Resolve medical coding edits or denials in relation to code assignment
Provide information or respond to questions from medical coding quality audits
Educate and mentor others to improve medical coding quality
Demonstrate basic knowledge of the impact of coding decisions on revenue cycle
Other duties as assigned