Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.  

In coordination with the Senior Coder, this position reviews, interprets and verifies diagnostic, clinical, and infusion codes for all oncology providers and extenders based on clinical reports within the EMR system and according to correct coding principles, current NCCI rules and LCD coverage determinations ensures that the proper codes are on all claims prior to submission for all charges for the cancer center. The coder is responsible for a thorough review of auditing all charges in both the inpatient and outpatient setting to ensure that compliance and charge capture are clean prior to claim submission. The coder also acts as a liaison to the physicians and clinical teams and provides feedback to physicians and management staff regarding proper documentation and coding and works within company standards to maintain policy and procedures. Meets coding and abstracting deadlines to expedite the billing and charge entry process and ensures best practices for the center is met according to departmental policy and procedures. This position is an integral player in daily functions and month end processes for both campuses for Hematology Oncology/Infusion/Radiation Oncology and works as a team player; this team member will be proficient in all areas as to ensure cross coverage to include: eligibility, authorization, and financial assistance.

Coding Compliance - Identifies unbundled procedures according to CPT guidelines and current Medicare NCCI rules. Identifies other coding related denials including medical necessity and modifier usage. Provides feedback to physicians and management staff regarding denials. Works directly with the PAA team members and provides feedback for related coding, denial management and proper modifier usage. Stays abreast of the latest oncology and infusion/radiation oncology service line coding to ensure proper compliance according to local, state, federal and national associations.

If you are located in Texas, you will have the flexibility to work remotely* as you take on some tough challenges

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High school diploma or equivalent
• Associates degree or 2+ years of experience in physician office setting
• CPC within 6 months from date of hire
• 2+ years of billing experience in a clinic or Physician Office setting
• 1+ years of coding experience abstracting from clinical notes or dictations 
• Diversified understanding of CPT guidelines and Medicare rules and regulations
• Solid understanding of Medical Terminology, excellent written and verbal communication skills
• Ability to work remotely with occasional mandatory on-site meetings

Preferred Qualifications:

• 5+ years of experience in health care billing and collection
• 2+ years of Outpatient Facility coding and billing experience
• Experience with EPIC
• Knowledge of secondary or supplemental insurance claim filing (COB)

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

OptumCare 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.