[Hiring] Edits/Denials Coder @UnitedHealth Group

Role Description

As a Senior Ambulatory Medical Coder Edits, you will work remotely to accurately determine CPT and ICD-10 Edits for all types of Professional Coding Services. 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.

This position is full-time (40 hours/week) Monday-Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

• Identify appropriate assignments of CPT and ICD-10 Edits for Professional Services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity accounts
• 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, as needed, 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, among others
• Participate in coding department meetings and educational events
• Additional responsibilities as identified by manager

Qualifications

• High School Diploma/GED
• Professional coder certification with credentialing from AHIMA and/or AAPC (CCA, CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC, and CPC-A) to be maintained annually
• 2+ years of Professional/Ambulatory coding experience for all chart types, Same Day Surgery, Observation, Emergency Department, Ancillary services, and Clinics
• 1+ years of experience working with LCD, NCD, Medical Necessity, Modifier Edits, OCE, MUE and NCCI classification and reimbursement structures
• 1+ years of experience working with coding payer denials
• Expert level of proficiency in CPT and ICD-10-CM coding
• Ability to use a PC in a Windows environment, including MS Excel and EMR systems

Requirements

• Experience with various encoder systems (Encoder, EPIC)

Telecommuting Requirements

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.