Surgical Medical Coder – Remote Nationwide

Requisition Number: 2263917
Job Category: Medical & Clinical Operations
Primary Location: Worcester, MA, US
(Remote considered)

Doctor consulting nurse at nurse station.

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 Coding specialist, you will be responsible for procedure and diagnostic coding of professional charges. Works closely with clinical department physicians and staff to ensure accurate and compliant coding and maximization of revenue through initial coding and appeals of payer rejections relating to coding.

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

Primary Responsibilities:

  • Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other providers of professional billing
  • Prepares, reviews, and transmits claims using billing software, including electronic and paper claim processing
  • Contacts providers or their representatives regarding inappropriate, incomplete or unclear coding
  • Searches for information in cases where the coding is complex or unusual. Forwards unresolved coding questions to manager for review and comment
  • Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations
  • Follows up on outstanding coding related receivables following standard Revenue Operations policy/procedure/process and based upon payer filing deadlines
  • Initiates refunds when appropriate for all third-party insurance receipts in accordance with governmental and insurance contract agreements
  • Ensures appropriateness of payer rejections and denials for coding related reasons
  • Contacts payers/governmental agencies regarding coding related denials and appeals as appropriate following established Revenue Operations policy/procedure/process
  • Notifies manager of any coding denial trends
  • Responds to coding related inquiries from providers and support staff and others as requested
  • Must keep current of governmental and other payor coding and reimbursement rules and requirements
  • Completes insurance and demographic registration updates as needed in conjunction with Registration Specialists
  • Reports accurate productivity and other data as requested
  • Maintains productivity, quality standards and processing timelines as established by Revenue Operations Metrics
  • Ensures compliance with payer filing deadlines
  • Cooperates fully with all governmental and third-party insurer audits
  • Adheres to all governmental and third-party compliance issues as directed
  • Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
  • Complies with established departmental policies, procedures, and objectives
  • Enhances professional growth and development through educational programs, seminars, etc.
  • Attends a variety of meetings, conferences, and seminars as required or directed
  • Performs other similar and related duties as required or directed
  • Regular, reliable and predicable attendance is required

What are the reasons to consider working for UnitedHealth Group?   Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
  • More information can be downloaded at: http://uhg.hr/uhgbenefits

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/ GED (or higher)
  • Certified in CPC, CCS-P, CPC-A
  • 2 + years of experience in Orthopedic surgery or Interventional Cardiology
  • Ability to learn the current billing software within 6 months of hire

Preferred Qualifications:

  • 2+ years of coding experience
  • 1+ of experience with third-party billing
  • 1+ years of knowledge of/experience in ICD-10, CPT and HCPCS coding or successful completion of related college course
  • Prior EPIC experience
  • Certified Coder – Billing and Coding 

Soft Skills:

  • Excellent organizational and communication skills
  • Ability to work independently and as part of a team
  • Demonstrate a professional and courteous manner when interacting with physicians/providers, clinical department staff and co-workers. 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii, Maryland, Washington, or Washington D.C Residents Only: The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii, Maryland, Washington, or Washington D.C residents is $19.47 to $38.08 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. 

 

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

 

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. 

 

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.

 

 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

 

 

#RPO #GREEN

Additional Job Detail Information

Requisition Number 2263917

Business Segment Optum

Employee Status Regular

Job Level Individual Contributor

Travel No

Country: US

Overtime Status Non-exempt

Schedule Full-time

Shift Day Job

Telecommuter Position Yes

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