[Hiring] Surgical Profee Medical Coder - Plastics & Dermatology @UnitedHealth Group

Role Description

Under direction of the Coding Manager, the primary responsibility of the Medical Coder is to ensure that codes representing current International Classification of Diseases, 9th Revision (ICD-9) or 10th Revision (ICD-10), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) accurately reflect documented services by applying a demonstrated knowledge of anatomy, physiology and medical terminology as well as compliant coding rules and regulations, including medical necessity and modifiers.

Additionally, the Medical Coder serves as the key resource to the Chief and Administrative Director and/or Manager regarding coding changes affecting assigned clinical areas, ongoing coding reviews of providers, and trends associated with coding utilization and optimization, denial management, reimbursement, and customer services issues. The Medical Coder is ultimately responsible for efficient charge capture and reconciliation processes (electronic or paper), knowing and meeting expected targets at sufficient accuracy rates as measured by Transaction Editing System (TES) edits, claim action report volumes, and denials. The Medical Coder will identify potential compliance concerns and/or barriers toward timely completion of all tasks to the Coding Manager and will endeavor to work in collaboration with colleagues in Coding, Clinical Departments, Health Information Management, Information Technology, and Finance toward viable solutions.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

• Charge Capture
  • Review charge capture documents, paper or electronic, for completeness and accuracy
  • Reconcile collection of charges to daily census report or schedules depending on place of service
  • Accurately indicate and link all ICD-10 diagnosis codes, procedure codes and modifiers on the charge document
  • Prepare daily charge capture documents according to Bassett policies and procedures
  • Process all pre-billing edits daily and complete each edit within 2 business days
  • Ensure charges are posted within the following timelines:
    • 4 days from date of service for Outpatient services
    • 7 days from date of service for Inpatient services
  • Monitor Lag Time Reports and work with practitioners and associated staff responsible for charge capture to meet those goals
• Denial Management
  • Process denials daily ensuring all requested timelines are met
  • Ensure procedure and ICD-10 codes reflect documentation
• Customer Service
  • Respond to customer service questions and report recurring issues to management
  • Work and communicate in a positive, cooperative manner with patients and their families when resolving customer service issues based on management observation and/or patient feedback
• Competency
  • Attend all staff meetings
  • Maintain current Coding Certification and active membership in the local AAPC chapter, including participation in local events and meetings
  • Have a good working knowledge of all hospital computer systems and coding tools available to assist with correct coding, including Epic’s Electronic Health Record application, MedAssets CodeCorrect application, and other department specific clinical/coding applications, e.g. CodeRyte
  • Keep abreast of coding changes and reimbursement reporting requirements and raise concerns to Coding Manager for resolution
  • Review and implement changes to departmental/site clinic sheets and charge documents to reflect current ICD-9 or ICD-10 in October, HCPCS and CPT’s in January
  • Abide by Standards of Ethical Coding as set forth by the AAPC or AHIMA (depending on certification) and adhere to Official Coding Guidelines as set forth by CMS and the OIG
• Coding Review and Reimbursement Resource
  • Conduct annual and focused reviews
  • Use interpersonal skills effectively to build and maintain cooperative working relationships with all levels and departments within the organization
  • Assist with the orientation, skill development and mentoring of employees new to the coding function based on management requests
  • Provide education to all providers within a given specialty based on coding trends and conduct new provider orientation
• Perform similar or related duties as requested or directed
• Perform other duties as requested and observed by supervisor or manager

Qualifications

• High School Diploma/GED (or higher)
• Professional coder certification with credentialing from AHIMA and/or AAPC (RHIA, RHIT, CCS, CCS-P CPC, OR CPC-H) to be maintained annually
• 3+ years of experience in Professional Services Surgery Coding (Plastics & Dermatology)
• 3+ years of experience working with CPT, HCPCS, ICD-10 codes, anatomy and physiology and medical terminology
• 3+ years of experience working with coding rules and regulations for issues regarding medical record documentation, compliance and reimbursement, including medical necessity, claims denials, bundling issues and charge capture

Telecommuting Requirements

• Ability to keep all company sensitive documents secure (if applicable)
• Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• Access to a dedicated work area established that is separated from other living areas and provides information privacy

Physical Requirements

• The position involves extensive work at the computer station

Pay and Benefits

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). The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment.

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.