Certified Medical Fee for Service Coder - Telecommute

Company: UnitedHealth Group
Location: Miami
Posted on: June 25, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
Review documentation to assure proper application of ICD-10 coding guidelines and policies
Application of appropriate CPT, CPTII, HCPCS, and modifiers necessary for accurate charge submission and reimbursement
Maintain defined charge submission turnaround times. Query providers for documentation clarification
Communicate with providers and clinic staff on a regular basis regarding documentation, coding and billing related issues

Essential Responsibilities:
Reviews provider documentation, diagnoses and charge codes for assigned providers or sites to ensure proper ICD-10CM, CPT, CPTII, HCPCS and modifiers are applied for appropriate reimbursement
Query providers or clinic staff as necessary for clarification of documentation or lack thereof as it pertains to proper application of ICD-10 diagnosis codes, E&M leveling and procedure code assignment
Codes for FFS and Commercial ACO population; ensures proper documentation and designation of HCC codes for ACO members
Reviews additional chart details and documentation as necessary to ensure proper diagnoses and procedure codes are applied; including reviewing orders, pathology, radiology, labs and other test results
Will work out of Touchworks EHR,and -Allscripts PM applications
Conducts physician chart audits for E&M and diagnosis coding as requested (includes research and presentation of finding and correct coding principles)
Expected to maintain a coding accuracy level of 95%
Maintains turnaround times as defined by Manager
Assists billing office staff with claims denials and corrections for re-billing purposes as needed
Conducts training sessions for physicians on relevant topics or updates, such as documentation guidelines, Medicare/Medicaid regulations, and coding requirements
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10 CM, CPT, and HCPCS II materials
Enhances professional growth and development through in-service meetings, educational programs, conferences, etc.
Will utilize coding tools provided, ICD-10, CPT, HCPCS books, and Encoder pro to perform accurate coding
Will meet productivity expectations and provide Manger with weekly productivity report
Will follow all CDO and OptumCare policies and coding guidelines.
Maintains strictest confidentiality
Performs other miscellaneous duties as required

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:
Certified Professional Coder (CPC) certificate
H.S. Diploma or equivalent with knowledge of medical terminology
2+ -years of experience in physician coding and/or reimbursement activities
Extensive knowledge and understanding of ICD-10 CM, CPT, HCPCS and coding guidelines
Familiar with third party fee profiles, claim edits and reimbursement requirements
Familiarity with ACO plans and applicable HCC diagnosis coding
Computer literate
Solid knowledge and understanding of regulatory compliance
Extensive knowledge and understanding of general coding principles
Ability to make simple mathematical computations
Familiarity with quality care measures and associated CPT II codes
Knowledge of encoder software and other coding applications/tools
Proficient with Microsoft Office applications (Outlook, Word, Excel)
Possesses working knowledge of commercial insurance and Medicare/Medicaid
Able to utilize electronic health record systems and other billing technologies
Understands HIPAA and other relevant regulations affecting patient information and billing practices
Preferred Qualifications:
Solid presentation skills and previous evaluation & management medical chart audit experience
Anatomy and physiology or other clinical knowledge of disease process
Must be detail-oriented and able to meet targeted deadlines
Solid communication skills (interpersonal, verbal and written, presentation)
Solid organizational and analytical thinking skills
Demonstrates critical thinking skills, and ability to interpret, assess, and evaluate provider documentation
Self-motivated and able to work independently without close supervision.
Skill in problem-identification and problem-resolution
Skill in exercising initiative, judgment, discretion and decision-making to achieve organizational objectives
Aptitude for establishing and maintaining effective working relationships with physicians and clinic staff
Equipment/Tools Used:
Laptop with Citrix environment, Allscripts TW, Allscripts PM and MS Office software
Work Environment/Schedule:
Remote/Telecommute. -Local travel is possible, contact with physicians, administrators and staff as necessary.

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)
Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $18.17 to $32.26. The hourly 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.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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.

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