Senior Medical Coder| Worcester, Massachusetts | Remote

Surgical Coding Team Lead

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Location:

Remote - Nationwide

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

Primary Responsibilities:

• Oversees surgical coding team of 8 coders. Facilities and monitors workflows. Assigns work daily and projects as needed
• Responsible for procedure and diagnostic coding of professional charges. Works closely with clinical department physicians and staff to ensure accurate and compliant coding and maximization of revenue through initial coding and appeals of payer rejections relating to coding
• Proves complex coding expertise in all functions of day to day processes, including Epic proficiency, exceptional communication both verbal and written and outstanding quality of work
• Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other providers of professional billing
• Contacts providers or their representatives regarding inappropriate, incomplete or unclear coding
• Search for information in cases where the coding is complex or unusual. Forward unresolved coding questions to manager for review and comment
• Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations
• Works directly with the auditors on coding documentation errors and payor updates. Communicates back to the team
• Works with team on workload to ensure month end completion and accuracy
• Follows up on outstanding coding related receivables following standard Revenue Operations policy/procedure/process and based upon payer filing deadlines
• Updates team on change to policies and coding changes
• Reviews coding denial reports with management
• Responds to coding related inquiries from providers and support staff and others as requested
• Must keep current of governmental and other payor coding and reimbursement rules and requirements
• Reports accurate productivity and other data as requested
• Maintains productivity, quality standards and processing timelines as established by Revenue Operations Metrics
• Ensures compliance with payer filing deadlines
• Adheres to all governmental and third-party compliance issues as directed
• Complies with established departmental policies, procedures, and objectives
• Performs other similar and related duties as required or directed
• Regular, reliable and predicable attendance is required

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
• Certified Coder - Billing and Coding preferred, Certified or Eligible for certification: CPC, CCS
• 3+ years of medical coding experience
• Medical terminology certificate or demonstrated knowledge
• Demonstrated knowledge and experience in ICD
  10, CPT and HCPCS coding or successful completion of related college course

Preferred Qualifications:

• Leadership experience
• Demonstrated knowledge of third- party billing
• Excellent organizational and communication skills. 3-5 years of work experience Ability to work independently and as part of a team
• Must demonstrate a professional and courteous manner when interacting with physicians/providers, clinical department staff and co-workers

* All Telecommuters will be required to adhere to United Health Group's Telecommuter Policy.

Pay is based on several factors…