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Pro-Fee Edits & Denials Medical Coder - National Remote

Company: UnitedHealth Group
Location: Hartford
Posted on: September 22, 2022

Job Description:

$3,000 Sign-On Bonus for External Candidates You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Healthcare isn't just changing. It's growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that's what fueled these exciting new opportunities. Who are we? -Optum360. We're a dynamic new partnership formed by Dignity Health and -Optum -to combine our unique expertise. As part of the growing family of -UnitedHealth -Group, we'll leverage our compassion, our talent, our resources, and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide. If you're looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It's an opportunity to do -your life's best work.SM This position is full-time (40 hours/week). Employees will have the opportunity to choose between Tuesday - Saturday or Sunday - Thursday (1 weekend day is required). It may be necessary, given the business need, to work occasional overtime. *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Primary Responsibilities:

  • Identify appropriate assignment of CPT and ICD-10 Codes for outpatient Ambulatory Observation services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
  • Expert knowledge in all Pro-Fee coding denials and edits for all specialties; General Surgery, Evaluation & Management, PT/OT, Lab, Emergency Room, and Trauma
  • Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits
  • 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, 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
  • Review and maintain a record of charts coded, held, and / or missing
  • Additional responsibilities as identified by manager
    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)
    • 3+ years of Outpatient physician coding (Pro-Fee) coding experience
    • Experience with ICD-10
    • Professional coder certification with credentialing from AHIMA and/or AAPC (ROCC, CPC, COC, CPC-P, CCS) to be maintained annually
    • Ability to use a PC in a Windows environment, including -Microsoft Excel (create and edit spreadsheets) -and EMR systems
    • Ability to work 40 hours/week. Hours are flexible; will have the opportunity to choose between Tuesday - Saturday or Sunday - Thursday (1 weekend day is required)
      Preferred Qualifications:
      • Experience with OSHPD reporting
      • Experience with various encoder systems (eCAC,3M, EPIC, Meditech)
      • Intermediate level of experience with Microsoft Excel (create, data entry, save)
        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
          UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status. Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military Learn how Teresa, a Senior Quality Analyst, -works with -military veterans and ensures they receive the best benefits and experience possible. -https://uhg.hr/vet Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So, when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $18.17 to $32.26. The salary range for Connecticut / Nevada residents is $20.00 to $35.53. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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. 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. Keywords: #RPO, #YELLOW

Keywords: UnitedHealth Group, Hartford , Pro-Fee Edits & Denials Medical Coder - National Remote, Other , Hartford, Connecticut

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