Instagram
youtube
Facebook

Subject Matter Expert

0-2 years
Not Disclosed
10 Jan. 13, 2025
Job Description
Job Type: Full Time Education: BHMS, BAMS, BPT/BDS/MBBS/B.Pharm Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Medical Coder - Remote Opportunity
Company: Optum (UnitedHealth Group)
Location: Remote
Department: Health Services

Company Overview
Optum is a global organization that leverages technology to provide care and resources to help millions live healthier lives. Our work connects people with healthcare, pharmacy benefits, data, and resources to help them feel their best. As part of UnitedHealth Group, we are committed to advancing health equity and improving health outcomes worldwide. Join us in making an impact on communities, advancing health equity, and helping individuals live healthier lives.

Job Description
As a Medical Coder, you will review, analyze, and interpret electronic medical records to identify diagnoses and procedures documented during patient admissions. You will determine and assign ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and other relevant information in accordance with official coding guidelines. You will collaborate with the clinical documentation team to ensure accuracy and completeness in documentation, and engage in continuous training to stay updated with coding changes.

Primary Responsibilities

  • Review and analyze electronic medical records to identify diagnoses and procedures for patient admissions.
  • Assign ICD-10-CM diagnosis codes, present on admission indicators, and ICD-10-PCS procedure codes according to official coding guidelines.
  • Collaborate with the Clinical Documentation Integrity Specialist (CDIS) team to clarify documentation and ensure accurate code assignment.
  • Sequence codes to meet compliance with ICD-10 coding guidelines, UHDDS, and other regulatory requirements.
  • Assess severity of illness and risk of mortality scores based on medical record documentation.
  • Confirm and correct Admission-Discharge-Transfer (ADT) information.
  • Identify areas for workflow improvement and contribute to quality and productivity processes.
  • Stay up-to-date with updates to the ICD-10 coding system and related regulations.
  • Provide expert coding advice and conduct training based on error trends.
  • Ensure compliance with company policies, procedures, and directives.

Required Qualifications

  • Education: Graduate/Postgraduate in Life Sciences or Allied Medicine (BHMS, BAMS, BPT, Dental Graduates, Pharmacists, Nurses).
  • Certification: Certified Coder (AAPC/AHIMA – CCS, CPC, CPC-H, CCS-P).
  • Experience: Extensive knowledge of medical terminology, human anatomy, physiology, pharmacology, and pathophysiology.
  • In-depth knowledge of ICD-10-CM/PCS coding systems and official coding guidelines.
  • Familiarity with external auditing programs (RAC, OIG, third-party payors).
  • Proficiency in interpreting medications, dosages, and ancillary test results.
  • Strong communication skills in English.
  • Proficient with Microsoft Office (Outlook, Word, Excel).
  • Strong critical thinking, analytical, and problem-solving abilities.
  • Self-motivated with the ability to work independently.
  • Ability to quickly analyze situations, prioritize tasks, and provide detailed feedback.
  • Flexibility to work varied hours, including weekends, to meet business needs.

Additional Information

  • This position offers the potential to work remotely.
  • UnitedHealth Group is committed to reducing barriers to healthcare and improving health outcomes for all, especially underserved populations.

Our Mission
At UnitedHealth Group, our mission is to help people live healthier lives by improving the health system. We are dedicated to delivering equitable care, reducing health disparities, and addressing the unique needs of historically marginalized communities.