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Job Details
$3,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS 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. As a Certified Sr. (IP) Acute Edits Medical Coder you will work remotely to correct CCI, MUE, and Medical Necessity Edits on accounts of all patient types in addition to periodic coding. You will ensure that all coding assignments are accurate according to coding policies and based on the documentation provided in the medical record. Using a thorough knowledge of coding policies and procedures as well as medical terminology and technology, you will be responsible for providing documentation feedback to physicians under the direction of the Coding Operations Manager or Quality Management personnel. Schedule: This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:
- Identify appropriate assignment of ICD-10-CM and ICD-10-PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC/MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
- Identify appropriate assignment of CPT and ICD-10 Codes for outpatient surgery, observation, emergency, and ancillary 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
- Abstract additional data elements during the Chart Review process when coding, as needed
- 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
- Provide documentation feedback to providers and query physicians when appropriate
- Maintain up-to-date Coding knowledge by reviewing materials disseminated/recommended by the QM Manager, Coding Operations Managers, and Director of Coding/Quality Management, etc
- Participate in coding department meetings and educational events
- Review and maintain a record of charts coded, held, and/or missing
- Additional responsibilities as identified by manager
- High School Diploma / GED (or higher)
- Professional coder certification with credentialing from AHIMA and/or AAPC (CCS, RHIA, RHIT, CIC, ROCC, CPC, COC, CPC-P) to be maintained annually
- 3+ years of recent inpatient medical coding experience (hospital, facility, etc.)
- 2+ years of recent working experience with OCE, MUE and NCCI classification and reimbursement structures
- 2+ years of experience working in a level I trauma center and/or teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding
- 2+ years of ICD-10 and DRG coding experience
- Ability to use a PC in a Windows environment, including MS Excel and EMR systems
- Experience with OSHPD reporting
- Experience with various encoder systems (eCAC,3M, EPIC)
- Intermediate level of proficiency with Microsoft Excel
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