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Job Details
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. 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. This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime and weekends. We offer 4 weeks of paid training. The hours during training will be 8:00am to 5:00pm, Monday - Friday. *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Primary Responsibilities:
- Assesses and interprets needs of the Ambulatory Coding Team by prioritizing work to meet deadlines.
- Identifies solutions to non-standard edits, workflows, and issues.
- Solves complex questions and conducts analysis of trends to provide education for the coding staff and clients including physicians/providers.
- Provides detailed education to the Coding Team and acts as a resource to others.
- Train and review assignments completed by new employees and provide post-hire reviews as needed.
- Apply expert coding knowledge to professional coding and billing initiatives and inquiries.
- Identify appropriate assignment of ICD-10-CM, CPT, and HCPCS II Codes for physician 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
- 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
- Understand federal coding register and ensure guidelines are used and followed appropriately.
- Understanding of appeal process with knowledge how to speak to denial and/or appeals.
- Provide documentation feedback to providers and query physicians when appropriate
- Maintain up-to-date Coding knowledge by reviewing materials disseminated/recommended by the Compliance, Coding Operations, etc.
- Participate in coding department meetings and educational events
- Strong knowledge of coding clinics and how to obtain education information.
- Process Rebills as appropriate.
- Other duties at the discretion of the Coding Supervisor
- High School Diploma / GED
- 3+ years of physician (pro-fee) medical coding experience in a multi-specialty physician clinic
- 2+ years of experience providing consultation and/or education to physicians and practitioners on coding guidelines and requirements
- Professional coder certification with credentialing from AHIMA and/or AAPC (CPC, CCS-P, RHIA, RHIT) to be maintained annually
- Expert level coding experience with a mastery of complex procedures in one or more the following specialty areas: Cardiothoracic, Vascular and Cardiac Catheterizations, Orthopedics, Neurology, Neurosurgery, General Surgery, OB/GYN, Hospitalist, and other specialties may be applicable.
- Intermediate knowledge of OCE, MUE and NCCI classification and reimbursement structures.
- Intermediate proficiency in Microsoft Office Suite
- Proficiency in various EMR software (i.e., EPIC, Cerner, AllScripts, 3M, etc.)
- Experience with Inpatient and Outpatient E/M (evaluation management) coding
- Must have experience with ICD-10, CPT, and HCPCS II
- Ability to travel up to 25%
- Must be 18 years of age OR older
- Ability to work full-time between 8:00am - 5:00pm including the flexibility to work occasional overtime given the business need
- Experience auditing charts in a professional coding environment
- Experience with various Encoder systems
- Knowledge of Medicare Ambulatory Payment Classification (APC) codes
- Firm understanding of federal coding guidelines
- Understanding of appeals/denials process
- Knowledge of coding clinics and how to obtain educational information
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
- Exceptional communication – both written and verbal
About the Company
UnitedHealth Group
Minnetonka, MN, United States
UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are... Read more