Senior Medical Coder - Remote Eligible

Senior Medical Coder

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. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

Join us to start Caring. Connecting. Growing together.

The Senior Medical Coder evaluates clinical coding from medical records to ensure accurate coding of encounter data and recommends processes to ensure accurate and efficient coding practices. They assist in providing feedback regarding coding and reimbursement. They participate in operational activities, work with network managers, medical directors, market leader, stakeholders and other employees to ensure improvement in coding accuracy. This position maintains high level (96%) coding accuracy and completes work within assigned queue in established timeframe and performs coding querying, adds missed codes, identifies deletes, code validation, identifies suspects, train Coders, educate providers, and perform audits.

Location: Remote Nationwide

Schedule: Monday - Friday 8:00 PM - 5:00 PM

Once training period is concluded; the option to modify schedule to time frame of choice to fulfill 40-hour work week, to include 4x10 shift schedule if desired.

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• 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)
• Other duties as assigned

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)
• Coding certification from AAPC or AHIMA professional coding association: (CPC, CPC-H, CPC-P, RHIT, RHIA, CCA, CCS, CCS-P etc.)
• 2+ years of HCC coding experience
• 2+ years of experience working with ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines
• 1+ years of experience in working medical terminology, disease process and anatomy and physiology

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.