Senior Medical Coder - Optum Tri-State

Optum in the tri-state region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group) offers an interconnected network that enables us to work collaboratively to better coordinate care among our doctors and care teams. Together, we offer you and your family access to more than 2,100 providers, representing 70 specialties, working in 360 medical practices and more than 55 urgent care locations across New York, New Jersey and Southern Connecticut.

We’re a dynamic and growing health care organization, offering a wide range of employment opportunities. We are seeking professional and dedicated individuals to be part of our team, where integrity, respect, accountability, and collaboration are among our core principles. Work with the largest care delivery organization in the world and start doing your life's best work.(sm)

The Senior Medical Coder reports to the Sr Manager, Optum National Revenue and demonstrates proficiency in all aspects of coding. The Senior Coder demonstrates experience by correlating coding accuracy with correct code assignments.

Accountabilities* Service Delivery - Ensures an accurate, efficient, and effective and timely team approach to daily operations of the Concurrent Coding/Auditing Services

* Staff Development and Management - Contributes to the development of staff capabilities to meet organizational goals and objectives

* Customer Service - Ensures the team provides excellent customer service to internal and external customers, Practices Servant Leadership management style with a focus on employee engagement

* Liaison and Communication/Teamwork - Leads and Promotes a team environment and enhances partnership and collaboration through effective communication ensuring an inclusive approach


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

Primary Responsibilities:

* 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

* Apply post-query response to make final determinations

* 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

* Educate and mentor others to improve medical coding quality

* Demonstrate basic knowledge of the impact of coding decisions on revenue cycle

* Attain and/or maintain relevant professional certifications and continuing education seminars as required

* Utilize and navigate across clinical software applications to assign medical codes or complete reviews


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:

* Must have a High School diploma, GED or equivalent

* Coding Certification from AAPC or AHIMA professional coding association: (CPC, CPC-H, CPC-P, RHIT, RHIA, CCA, CCS, CCS-P etc. )

* 3 years of coding experience

* An excellent understanding of ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines

* An excellent understanding of medical terminology, disease process and anatomy and physiology


Preferred Qualifications:

* Revenue Cycle experience

* Task oriented and able to meet designated deadlines and productivity standards


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 equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

CareMount Medical, ProHEALTH Care Associates, and Riverside Medical Group (the “Practices”) are all physician owned and led practices having complete authority for all medical decision-making and patient care through their physicians and other licensed professionals. Optum, through its management organizations (“Optum”) provides non-clinical administrative services to support the Practices and their physicians. Neither Optum nor its management companies employs, engages, or supervises physicians or other licensed professionals, or determines or sets the methods, standards, or conduct of the practice of medicine or health care provided by the Practices or by any of their licensed professionals. “Part of Optum” reflects that the Practices are part of Optum’s effort to support forward-thinking physician practices in helping their patients live healthier lives.

California, Colorado, Connecticut, Nevada, New York City, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New York City, or Washington residents is $22.45 to $43.89. 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.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.

Salary : $22 - $0