Certified Medical Fee for Service Coder - Telecommute
Company: UnitedHealth Group
Location: Miami
Posted on: June 25, 2022
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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.
Keywords: UnitedHealth Group, Miami , Certified Medical Fee for Service Coder - Telecommute, Healthcare , Miami, Florida
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