Senior Medical Coder

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.

Primary Responsibilities:

• Extensive work experience within own function
• Work is frequently completed without established procedures.
• Works independently.
• May act as a resource for others.
• May coordinate others¿ activities.Extensive work experience within own function.
• Work is frequently completed without established procedures.
• Works independently.
• May act as a resource for others.
• May coordinate others’ activities.
• Applies knowledge/skills to a range of moderately complex activities.
• Demonstrates great depth of knowledge/skills in own function.
• Sometimes acts as a technical resource to others in own function.
• Proactively identifies solutions to non-standard requests.
• Solves moderately complex problems on own.
• Works with team to solve complex problems.
• Plans, prioritizes, organizes and completes work to meet established objectives.
  May coordinate work of other team members
• Leverage understanding of disease process to identify and extract relevant details and data within clinical documentation and
  make determinations or identify appropriate medical codes
• Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code
  applicability, rules, and guidelines
• Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary
  services) to assign appropriate medical codes
• Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes
• Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information
• Follow up with providers as necessary when responses to queries are not provided in a timely basis
• Utilize medical coding software programs or reference materials to identify appropriate codes
• Read and interpret medical coding rules and guidelines to make decisions (e.g., exclusions, sequencing, inclusions)
• Apply post-query response to make final determinations
• Make determinations on medical charting and take initiative to complete reviews independently to avoid delays in the process
• Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations.
• Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters)
• Resolve medical coding edits or denials in relation to code assignment
• Provide information or respond to questions from medical coding quality audits
• Perform medical coding audits to evaluate medical coding quality
• Review medical coding audit results
• Follow steps per agreement with medical coding audit results to resolve discrepancies
• Provide resources and information to substantiate medical coding audit findings
• Educate and mentor others to improve medical coding quality
• Apply understanding of National Correct Coding Edits to the coding process
• Demonstrate understanding of National and Local coverage determinations
• Demonstrate basic knowledge of the impact of coding decisions on revenue cycle
• Follow relevant professional code of ethics consistent with required certifications
• Attain and/or maintain relevant professional certifications and continuing education seminars as required
• Leverage relevant computer software programs (e.g., Microsoft Office) to record information, analyze data, or communicate with others
• Utilize and navigate across clinical software applications to assign medical codes or complete reviews
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Any Life Science Graduates With CPC and AHIMA and/or AAPC
• 3+ years Experience in HCC Medical Coding 

Preferred Qualification: 

• Experience in CPT Coding

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.