Health care isn't just changing. It's growing more complex every day. Because of this hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. 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)
Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member - centric approach to care. As an Inpatient Medical Coder you will determine and record the correct medical codes for all treatments and health services. Ensuring proper records is just one way your work will impact the health and wellness of our members on a huge scale.
Who are we? We're 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 health care providers nationwide.
As a Medical Coder / Claims Analyst you will work remotely to correct CCI, MUE, and Medical Necessity Edits on accounts of all patient types in addition to periodic coding. 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.
You’ll enjoy the flexibility to
telecommute from anywhere within the U.S. as you take on some tough
challenges. Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter policy. This is a part-time position with UP TO 20 hours per week.
- Apply coding knowledge to analyze / correct CCI Edits and Medical Necessity accounts
- Identify appropriate assignment of ICD-10-CM and ICD-10-PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC / MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
- Identify appropriate assignment of CPT and ICD-10 Codes for outpatient surgery, observation, emergency, and ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
- 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 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, etc.
- Participate in coding department meetings and educational events
- Review and maintain a record of charts coded, held, and / or missing
- High School Diploma / GED or higher
- Professional coder certification with credentialing from AHIMA and / or AAPC (CCS, RHIA, RHIT, CIC, ROCC, CPC, COC, CPC - P) to be maintained annually
- 3+ years of Inpatient medical coding experience (hospital, facility, etc.)
- 2+ years of Outpatient Facility Surgery coding experience
- Experience with OCE, MUE and NCCI classification and reimbursement structures
- 3+ years experience working in a level I trauma center and/or teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding
- 3+ years must have ICD-10 and DRG coding experience
- Ability to use EMR systems for coding and computer assisted coding
- Ability to have a flexible work schedule and work on a short notice, up to 20 hours per week and with the possibility of working mandatory overtime, weekends or holidays
- Experience with OSHPD reporting
- Experience with various encoder systems (eCAC,3M, EPIC)
- Intermediate level of
experience with Microsoft Excel (able to create, modify and edit documents)
This is a virtual, remote, position that requires candidates to be highly organized, self - starters, well - versed in technical applications. Previous success in a remote environment is preferred. The work schedule is flexible. Typically, Sunday through Thursday or Tuesday through Saturday with set hours as established between manager and coder may require weekend and/or holiday coverage to meet business needs as well as the possibility of mandatory overtime.
Careers with OptumInsight. Information and
technology have amazing power to transform the Healthcare industry and improve
people's lives. This is where it's happening. This is where you'll help solve
the problems that have never been solved. We're freeing information so it can
be used safely and securely wherever it's needed. We're creating the very best
ideas that can most easily be put into action to help our clients improve the
quality of care and lower costs for millions. This is where the best and the
brightest work together to make positive change a reality. This is the place to
life’s best work.SM
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: casual employee, part time, coding, telecommute