Outpatient Medical Coder Edits - Remote Nationwide

  • $3,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS
  • 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. Come make an impact on the communities we serve as we help... advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and 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 a 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. As a Medical Coder you will work remotely to accurately determine CPT and ICD-10 Codes for all types of same day surgeries, major Trauma ER encounters, observations, and complex surgery cases including orthopedic and spinal fusions. 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.
  • Work Schedule: Full-time (40 hours/week) Monday- Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours. It may be necessary, given the business need, to work occasional overtime.
  • You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
  • Primary Responsibilities:
  • ? Identify appropriate assignment of CPT and ICD-10 Codes for outpatient surgery, observation, CVIR, emergency, and ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
  • ? Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity accounts
  • ? 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)
  • ? Professional coder certification with credentialing from AHIMA and/or AAPC (ROCC, CPC, COC, CPC-P, CCS) to be maintained annually
  • ? 2 years of Outpatient Facility coding experience
  • ? Experience with ICD-10
  • ? Experience with LCD, NCD, Medical Necessity, Modifier Edits
  • ? Ability to use a PC in a Windows environment, including Microsoft Excel and EMR systems
  • ? Ability to work flexible hours; Monday- Friday - 40 hours/week, including the flexibility to work occasional overtime per business need
  • Preferred Qualifications:
  • ? Experience with complex cardiac catheterizations and interventional radiology (CVIR/IVR)
  • ? Experience with various encoder systems (eCAC,3M, EPIC)
  • ? Intermediate level of experience with Microsoft Excel
  • ? Experience with OSHPD reporting
  • Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equit
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