For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

The Senior Coder reports to the Manager, Coding & Auditing and demonstrates proficiency in all aspects of coding. The Senior Coder demonstrates experience by correlating coding accuracy with correct code assignments.

Primary Responsibilities:

• Leverage understanding of disease process to identify and extract relevant details and data within clinical documentation and make determinations or identify appropriate medical codes
• Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines
• 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
• Read and interpret medical coding rules and guidelines to make decisions (e.g., exclusions, sequencing, inclusions)
• Apply post-query response to make final determinations
• Make determinations on medical charting and take initiative to complete reviews independently to avoid delays in the process
• 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)
• Resolve medical coding edits or denials in relation to code assignment
• Provide information or respond to questions from medical coding quality audits
• Perform medical coding audits to evaluate medical coding quality
• Review medical coding audit results
• Follow steps per agreement with medical coding audit results to resolve discrepancies
• Provide resources and information to substantiate medical coding audit findings
• Educate and mentor others to improve medical coding quality
• Apply understanding of National Correct Coding Edits to the coding process
• Demonstrate understanding of National and Local coverage determinations
• Demonstrate basic knowledge of the impact of coding decisions on revenue cycle
• Follow relevant professional code of ethics consistent with required certifications
• Attain and/or maintain relevant professional certifications and continuing education seminars as required
• Leverage relevant computer software programs (e.g., Microsoft Office) to record information, analyze data, or communicate with others
• Utilize and navigate across clinical software applications to assign medical codes or complete reviews

Accountabilities:

• Integrity Value: Act Ethically
  • Comply with Applicable Laws, Regulations and Policies
  • Demonstrate Integrity
• Compassion Value: Focus on Customers
  • Identify and Exceed Customer Expectations
  • Improve the Customer Experience
• Relationships Value: Act as a Team Player
  • Collaborate with Others
  • Demonstrate Diversity Awareness
  • Learn and Develop
• Relationships Value: Communicate Effectively
  • Influence Others
  • Listen Actively
  • Speak and Write Clearly
• Innovation Value: Support Change and Innovation
  • Contribute Innovative Ideas
  • Work Effectively in a Changing Environment
• Performance Value: Make Fact-Based Decisions
  • Apply Business Knowledge
  • Use Sound Judgement
• Performance Value: Deliver Quality Results
  • Drive for Results
  • Manage Time Effectively
  • Produce High-Quality Work

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 equivalent
• Coding certification (CPC) or other appropriate certification through AAPC or AHIMA
• 3+ years of coding experience in an outpatient environment
• Excellent understanding of ICD-10-CM coding classification and guidelines
• Excellent understanding of CPT, HCPCS, and modifier coding and guidelines
• Excellent understanding of medical terminology, disease process and anatomy and physiology
  

Preferred Qualifications:

• Supervisory experience
• Revenue Cycle experience
• CLL- Practices for Success -Individual
  

Resilience & Resourcefulness

• Achievement Drive
• Serving Customers
• Collaborating
• Building Relationships
• Communicating with Others
• Persevering
• Self-Management
• Applying Life-Long Skill Building Effort
• Building and Applying Technical and Functional Skills
• Providing Support
• Managing Conflict
• Using Performance Measures
• Supporting Innovation and Creativity
• Growth Mindset
• Managing Ambiguity and Uncertainty
• Being Coachable
• Taking Initiative and Risks
• Using Time and Resources Efficiently
• Delivering Results
• Adding Value
• Solving Problems
• Understanding Goals, Priorities and Plans
• Influencing Others
• Using Humor
• Understanding the Enterprise
  

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.




Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.