Medical Coder jobs at Humana

This position will be functioning under minimal supervision while utilizing independent decision making. This position will assist the manager and supervisor in training new team members, coordinate inquiries from ancillary departments regarding DNFB and edit tasks. The Sr. Edit Coder will investigate and solve edit issues and communicate root cause data to management in order mitigate potential upstream and downstream impacts. Responsible for modifying and completing moderate to high complexity reviewing and resolving coding and charge edits using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Working in billing editor systems as required. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Performs claim edit reviews on outpatient encounters to validate appropriateness of the CPT codes, HCPCS Level II codes, and modifier assignments, APC group appropriateness, review for missed secondary diagnoses and/or procedures, and ensure compliance with all APC mandates and outpatient reporting requirements. Monitors medical visit code selection by departments against facility specific criteria for appropriateness. Assists in the development of such criteria as needed. Addresses CCI and LCD edits within the various billing editors while abiding by the Standards of Ethical Coding as set forth by the American Health Information Management Association. Meets and/or exceeds Conifer's Edit Coder productivity standards. * Runs and submits coding operational reports to leadership as requested, reviews data and identifies opportunities or trends. Demonstrates working knowledge of DNFB and uses data to drive performance excellence. Ability to analyze, display, and communicate data in meaningful manner. Ability to maneuver thru various electronic systems effectively. * Ability to deal with customer/partner issues and resolve conflict. Ability to multi-task and meet deadlines. Will act as a resource for Edit Coders. * Reviews claim denials and utilizes the medical record in determining accurate code assignment of all documented diagnoses and procedures adhering to the standards of ethical coding. * Monitors DNFB report for outstanding and/or uncoded encounters to ensure timeliness of coding completion. Brings identified issues to department managers for resolution. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Three years minimum hospital outpatient coding/edit experience * Advanced personal computing skills including MS Outlook, MS Word, MS Excel * Advanced technical skills required to learn and navigate a variety of software systems, trouble-shoot computer problems, and work efficiently in a virtual environment * Strong written and verbal communication skills * Ability to think/work independently, yet interact positively with team * Advanced problem-solving skills and ability to quickly analyze a situation. * Comprehensive knowledge of ICD-10 and CPT coding systems. * Strong knowledge base of changes in LCDs and NCDs. * Strong knowledge base of current NCCI and OCE guidelines * Attention to detail is critical to this position * Other functions as deemed necessary to complete and final bill claims accurately Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. * Previous auditing experience or strong training background in coding and reimbursement * Outstanding interpersonal communication skills as well as excellent oral and written communication skills * Comprehensive knowledge of the APC structure and regulatory requirements. * Knowledge of medical terminology, anatomy and physiology, disease process, and surgical procedures CERTIFICATES, LICENSES, REGISTRATIONS Required: AHIMA RHIT or RHIA or AAPC CCS, CPC approved credential PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to lift 15-20lbs * Ability to sit and work at a computer for a prolonged period of time * Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Office/Hospital Work Environment * Works in a private office space in the coder's home per Conifer Telecommuter Policy as defined in the Telecommuting Program Guide OTHER Must be able to travel nationally as needed, not to exceed 10% As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $24.82 - $37.23 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. At CHS, our coding team recognizes your individual talents, encourages professional development, and provides opportunity for career advancement. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 14 states, CHS is committed to helping people get well and live healthier. CHS operates 70 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. **Job Summary** As a member of the 100% US Based HIM Central Services coding team, the Coder IP provides inpatient coding assistance for a set of HIM Central Services-supported CHS hospitals. The coder IP reviews patient records and assigns accurate codes for each diagnosis and procedure, applying knowledge of medical terminology, disease processes, and pharmacology while demonstrating strong data quality and integrity skills. Independent decision-making is required for accurate **ICD-10-CM** and **PCS** code assignments, which play a key role in determining CHS's reimbursement potential while ensuring adherence to compliant coding standards and corporate policies for accurate billing. **Essential Functions** + Performs remote coding for CHS hospitals for all inpatient types via review of electronic medical records. + Primarily codes inpatient records and may have experience in outpatient coding. + Submits queries to providers for documentation clarification to include diagnosis clarification based on clinical indicators and coding specificity requirements. + Consults the Manager, Corporate Coding or other available resources and works out difficult codes and/or coding problems. + Attends coding education as scheduled. + Maintains productivity levels set forth by Community Health Systems while maintaining a 95% coding accuracy rate. + Collaborates with facility CDI to ensure complete and accurate final coding based on available documentation. + Performs other duties as assigned. + Complies with all policies and standards. **Qualifications** + H.S. Diploma or GED required + Associate Degree in Health Information Management or related field preferred or + 1 year coding certification in Health Information Management or related field preferred + 1-3 years acute care hospital inpatient coding experience including coding complex cardiac and neuroscience procedures required + 1-3 years Experience with virtual desktop image, electronic medical record systems, encoding systems as well as word processing and spreadsheet software required **Knowledge, Skills and Abilities** + Knowledge of related prospective payment systems, anatomy, physiology, and medical terminology. + Broad knowledge of pharmacology indications for drug usage and related adverse reactions. + Ability to maintain confidentiality of patient information in accordance with HIPAA guidelines. + Ability to work effectively with co-workers, management and physicians. + Ability to read and understand oral and written instructions and follow written protocols. **Licenses and Certifications** + Certified Coder-AHIMA or AAPC Certified Inpatient Coder (CIC) required or + Certified Coder-AHIMA or AAPC Certified Coding Specialist (CCS) required or + RHIT - Registered Health Information Technician AHIMA RHIT required or + RHIA - Registered Health Information Administrator AHIMA RHIA required or Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.

The Remote Physician Pro Fee Coding Specialist-Orthopedics is responsible for reviewing, analyzing, and assigning accurate CPT, HCPCS, and ICD-10 codes for professional fee services documented in the medical record. This role ensures proper sequencing, modifier use, and place-of-service coding in compliance with governmental regulations, third-party payer policies, and corporate standards. The Physician Coder plays a key role in revenue cycle accuracy by identifying documentation gaps, ensuring coding integrity, and working collaboratively with internal teams to support physician coding compliance and reimbursement. **Essential Functions** + Assigns accurate CPT, HCPCS, and ICD-10 codes for professional services, procedures, diagnoses, and treatments based on provider documentation. + Ensures compliance with governmental regulations, third-party payer policies, and corporate coding protocols, following National Correct Coding Initiative (NCCI) edits, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs). + Performs coding audits and quality reviews, verifying accuracy of documentation and identifying areas for provider education. + Works coding-related claim edits, holds, and scrubs in the electronic billing system (e.g., Athena Collector), ensuring timely claim resolution and reimbursement. + Collaborates with physicians, revenue cycle teams, and coding education staff, requesting clarification when necessary to ensure optimal documentation and compliance. + Performs edit checks on coded data before transmittal, identifying and correcting errors as needed. + Maintains strict confidentiality of patient records, provider information, and financial data, adhering to HIPAA and corporate compliance policies. + Escalates documentation or coding issues to the coding education team for provider training and improved documentation practices. + Assists in coding-related special projects, ensuring accurate reporting and analysis of coding data for operational improvement. + Performs other duties as assigned. + Maintains regular and reliable attendance. + Complies with all policies and standards. **Qualifications** + H.S. Diploma or GED required + Associate Degree in Health Information Management, Healthcare Administration, or a related field preferred + 2-4 years of experience in physician coding, professional fee coding, or medical billing required + Experience with multiple specialties, surgical coding, or high-volume professional fee coding preferred **Knowledge, Skills and Abilities** + Strong knowledge of ICD-10, CPT, and HCPCS coding systems for physician/professional fee services. + Understanding of modifier usage, place-of-service coding, and payer billing guidelines. + Experience with electronic health records (EHR), coding software, and claim processing systems. + Ability to identify documentation deficiencies and escalate for provider education. + Familiarity with NCCI edits, LCD/NCD guidelines, and medical necessity requirements. + Strong analytical and problem-solving skills, ensuring accurate coding and optimal reimbursement. + Effective communication and collaboration skills, working with providers, revenue cycle teams, and compliance staff. **Licenses and Certifications** + Certified Coder-AHIMA or AAPC (CPC) required or + CCS-Certified Coding Specialist (CCS-P) required + Additional certifications such as Certified Evaluation and Management Coder (CEMC) or Registered Health Information Technician (RHIT) preferred Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.

The primary purpose of the SPEC, PHYS SVC CODING II is to code physician charges by assigning ICD-10, CPT, HCPCS codes and modifiers from medical record documentation. Must have the ability to utilize multiple resources to support code assignment. Must possess knowledge on how to resolve coding denials and pre-bill coding edits. Productivity and accuracy are measured via internal audits and must be maintained. Level II roles include but are not limited to evaluation and management coding, radiology, and emergency department coding. ESSENTIAL DUTIES AND RESPONSIBILITIES * Assign ICD-10, CPT, HCPCS and modifiers codes from documentation * Review and appropriately resolve pre-bill edits * Review and appropriately resolve coding denials * Meet or exceed productivity standards * Meet or exceed accuracy rate of 95.5% in monthly internal audits * Effectively present coding issues to internal team members, internal clients, or external clients * Deliver information in a one-on-one or small group format to peers * Meet deadlines and complete assignments before monthly closing dates * Locate and apply CCI, LCD, NCD and other applicable coding rules and client specific guidelines * Other duties as assigned Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE * Vocational or technical education beyond high school * Minimum of 3-5 years coding experience * CPC or CCS-P or equivalent certification Multi-specialty Evaluation and Management coding * Demonstrate working knowledge of medical terminology, human anatomy, and coding rules and regulations * Must possess knowledge of third-party reimbursement regulations and billing practices * Ability to examine documents for accuracy and completeness * Detail oriented with the ability to identify and resolve problems * Must possess knowledge of CCI, LCD, NCD and other applicable coding rules and regulations * Detail oriented with the ability to identify and resolve problems * Ability to communicate clearly and work effectively with co-workers * Ability to work as a team member in all activities * Conduct self in an ethical, honest, and professional manner * Demonstrate continued willingness to learn and grow * Proficient in Microsoft Word, Excel POSITION COMPETENCIES: * Builds Team Relationships - Invites others to share opinions. Partners with employees in other departments. Actively seeks ways to help team members. * Communicates Effectively - Expresses ideas clearly and succinctly with small or large audiences. Listens attentively to speaker's message without interruption. Tailors writing to audience using correct grammar and spelling. * Compliance with Laws, Policies and Procedures - Adheres to company handbook and policies. Demonstrates behavior consistent with Code of Conduct. Adheres to compliance program and guidelines. * Develops Self - Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development. * Displays Adaptability - Performs well in high pressure or stressful situations. Works effectively when direction is unclear or rapidly changing. Demonstrates persistence in the face of obstacles. * Drives for Results - Delivers high quality work and attains results. Demonstrates personal drive and pushes self and others for results and quality work. Response appropriately to urgent situations. * Focus on the Customer/Client - Ensures that clients have a positive experience. Responds to clients in a timely manner. Demonstrates tact and empathy when responding to clients. * Respects Others - Displays sensitivity to the needs and concerns of others. Interacts with others in an open, non-threatening manner. * Shows Reliability - Takes personal responsibility for actions and decisions. Consistently works assigned schedule. Acts responsibly and can be counted on to accomplish goals successfully. Compensation and Benefit Information Compensation Pay: $20.51 - $30.77 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others. Our Impact Today Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions. Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions. Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day. Tenet Healthcare has immediate needs for remote, home-based Inpatient Corporate Coders to support the hospital business. Corporate Coders can be based anywhere in the country with home internet access. The Corporate Coder ("CC") functions under the direction of the Health Information Corporate Coding Manager. The CC is responsible for accurate coding and abstracting of clinical information from the medical record. The CC is responsible for maintaining standards for coding data quality and integrity, as well as productivity within established guidelines. The CC is responsible for coding of Tenet facilities as assigned, assisting with productive coding to maintain DNFC, assisting with quality chart reviews, assisting with the training of new CC's and/or other projects where indicated. * Accurately and productively code/abstract patient health documentation for Tenet facilities. * Utilize coding abilities to review flagged cases, in CARDS and RevInt for coding accuracy. * Assisting in coding quality reviews/audits and second level reviews as needed. * Attends Tenet coding educations and maintains coding credentials. Required: * Associates or higher-level degree in a Health Information Management discipline. * 1-3 years inpatient coding experience. * Skilled and working knowledge of MS Office suite. * Strong technical background and electronic medical record experience. * Successful completion of at least one AHIMA (American Health Information Management Association) certified program with achievement of the correlating professional credential preferred (RHIA, RHIT, and / or CCS, etc.). Preferred: * Bachelor's or higher-level degree in a Health Information Management discipline. * 3+ years of inpatient coding experience. * Coding experience in a large, complex health system. A pre-employment coding proficiency assessment will be administered. Compensation * Pay: $26.40 to $39.00 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Observed holidays receive time and a half. Benefits The following benefits are available, subject to employment status: * Medical, dental, vision, disability, life, AD&D and business travel insurance * Paid time off (vacation & sick leave) * Discretionary 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance. * For Colorado employees, paid leave in accordance with Colorado's Healthy Families and Workplaces Act is available. Tenet Healthcare complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law. #LI-CM7 Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

The Cardiology Physician Coder is responsible for reviewing, analyzing, and assigning accurate CPT, HCPCS, and ICD-10 codes for professional fee services documented in the medical record. This role ensures proper sequencing, modifier use, and place-of-service coding in compliance with governmental regulations, third-party payer policies, and corporate standards. The Physician Coder plays a key role in revenue cycle accuracy by identifying documentation gaps, ensuring coding integrity, and working collaboratively with internal teams to support physician coding compliance and reimbursement. Essential Functions Assigns accurate CPT, HCPCS, and ICD-10 codes for professional services, procedures, diagnoses, and treatments based on provider documentation. Ensures compliance with governmental regulations, third-party payer policies, and corporate coding protocols, following National Correct Coding Initiative (NCCI) edits, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs). Performs coding audits and quality reviews, verifying accuracy of documentation and identifying areas for provider education. Works coding-related claim edits, holds, and scrubs in the electronic billing system (e.g., Athena Collector), ensuring timely claim resolution and reimbursement. Collaborates with physicians, revenue cycle teams, and coding education staff, requesting clarification when necessary to ensure optimal documentation and compliance. Performs edit checks on coded data before transmittal, identifying and correcting errors as needed. Maintains strict confidentiality of patient records, provider information, and financial data, adhering to HIPAA and corporate compliance policies. Escalates documentation or coding issues to the coding education team for provider training and improved documentation practices. Assists in coding-related special projects, ensuring accurate reporting and analysis of coding data for operational improvement. Performs other duties as assigned. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Associate Degree in Health Information Management, Healthcare Administration, or a related field preferred 2-4 years of experience in physician coding, professional fee coding, or medical billing required Experience with multiple specialties, surgical coding, or high-volume professional fee coding preferred Knowledge, Skills and Abilities Strong knowledge of ICD-10, CPT, and HCPCS coding systems for physician/professional fee services. Understanding of modifier usage, place-of-service coding, and payer billing guidelines. Experience with electronic health records (EHR), coding software, and claim processing systems. Ability to identify documentation deficiencies and escalate for provider education. Familiarity with NCCI edits, LCD/NCD guidelines, and medical necessity requirements. Strong analytical and problem-solving skills, ensuring accurate coding and optimal reimbursement. Effective communication and collaboration skills, working with providers, revenue cycle teams, and compliance staff. Licenses and Certifications Certified Coder-AHIMA or AAPC (CPC) required or CCS-Certified Coding Specialist (CCS-P) required Additional certifications such as Certified Evaluation and Management Coder (CEMC) or Registered Health Information Technician (RHIT) preferred

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be willing to travel to NYC twice a year for required meetings. Position Purpose: The focus of this position is to establish processes to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review. Analyze moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance. Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. Provide regular reports on project status and progress; report project results to identify coding improvement opportunities. Collaborate with other business units to identify and implement process efficiency and quality improvement practices. Work with IT resources to implement system efficiencies and configuration enhancements to improve claims processing operations. Apply Coding Guidelines as described in the ICD-10 Coding Manual. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: RN Degree. One year experience preferred in hospital inpatient coding. Nursing experience in managed care organization or acute care hospital. One year of experience in a clinical setting or acute care hospital; RN, PA, MD, APRN, DO or MBBS license required. Coding Credential Required: Valid/Current CPC Certification, through APPC preferred or CIC through AAPC or CCS through AHIMA; RHIA/RHIT Credentials-Preferred. Pay Range: $68,700.00 - $123,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Job Description Opportunities for you! Consecutively recognized as a top employer by Forbes Vacation time starts building on Day 1, and builds with your seniority 403(b) retirement plan with up to 7% matching contributions Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams. Want to learn more? Click here. Responsibilities This role serves the entire Community Health System as part of a team of over 30 people made up of coders, clerical support and educators. This team works together to meet and exceed common goals. In this remote position, you will assign ICD-10-CM/PCS and CPT-4 codes for statistical and reimbursement requirements to inpatient and/or outpatient accounts. We use the most current and up-to-date technology and software, meaning you will have the constant opportunity to grow and learn in your role! Review charts thoroughly to ascertain all diagnosis and procedures. Code all diagnoses and procedures in accordance to ICD-10-CM/PCS and CPT-4 coding practices, rules and guidelines for all inpatient services, observation and ambulatory accounts. Maintains 99% rate of information correctly abstracted. Completes abstract competency annually. Maintain the knowledge base necessary for current coding practices and remain up to date with the following manuals: Administration, Health Information Management Services, Emergency Management and Safety. Whether working independently or alongside teammates, you'll contribute to a standard of excellence that defines the Community experience from day one! Qualifications Education & Experience High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required Completion of courses in Medical Terminology, Anatomy and Physiology required 5 years of recent inpatient coding experience in an acute care setting required Proficient in ICD-10-CM/PCS and CPT-4 coding, DRG and APRDRG assignment required Licenses and Certifications CCS - Certified Coding Specialist required Fully Remote

Explore opportunities with Shared Services, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As a Coding Specialist, you will review medical record documentation submitted by clinicians and subsequently assign the proper International Classification of Disease numerical codes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Review medical records and assign codes + Follow official coding guidelines per CMS and ICD rules + Ensure documentation supports codes + Consult clinicians for clarification + Educate and maintain positive communication with clinicians + Follow workflow processes to maintain productivity standards 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:** + Clinician or a Registered Health Information Administrator (RHIA) or be certified as a Home Care Specialist - Diagnosis (HCS-D) + Successfully pass the HCS-D certification exam within 90 days of employment and maintain HCS-D certification annually **Preferred Qualifications:** + 1+ years of professional work experience + Effective Verbal and Communication *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Explore opportunities with Lafayette Home Office, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As a Coding Specialist, you will review medical record documentation submitted by clinicians and subsequently assign the proper International Classification of Disease numerical codes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Review medical records and assign codes * Follow official coding guidelines per CMS and ICD rules * Ensure documentation supports codes * Consult clinicians for clarification * Educate and maintain positive communication with clinicians * Follow workflow processes to maintain productivity standards 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: * Clinician or a Registered Health Information Administrator (RHIA) or be certified as a Home Care Specialist - Diagnosis (HCS-D) * Successfully pass the HCS-D certification exam within 90 days of employment and maintain HCS-D certification annually Preferred Qualifications: * 1+ years of professional work experience * Effective Verbal and Communication * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes Develop and maintain the audit process and tools related to: authorizations, appeals, quality events, and case management in CCMS; interrater reliability related to InterQual; and data entry into the credentialing subsystem Develop and maintain the audit schedule Audit staff as outlined in the system auditing policies Train audit staff at the health plan in the use of audit process and tools Facilitate compliance with the auditing process Act as a consultant related to system auditing to others in the unit, department and health plan Work with staff to identify and resolve authorization load error report system problems Coordinate auditing outcomes with the Trainer to identify, develop and publish corrective actions/educational material related to audit errors Coordinate auditing outcomes and system maintenance with the Sr. Clinical Systems Specialist to resolve or enhance clinical systems Performs other duties as assigned Complies with all policies and standards ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN MISSOURI***Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience. Education/Experience: Bachelor's degree in related field or equivalent experience. 3+ years of related experience. For Home State Health Plan only: State unrestricted license as Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse (RN), or Licensed Practical Nurse (LPN) Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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 performs concurrent review of FFS coding rules in Athena, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. Schedule: Monday to Friday, 6 AM- 6 PM PST, 40 hours/week Location: Remote - Nationwide You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * 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 on 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) * Resolve medical coding edits or denials in relation to code assignment * Provide information or respond to questions from medical coding quality audits * Demonstrate basic knowledge of the impact of coding decisions on revenue cycle * Attain and/or maintain relevant professional certifications and continuing education seminars as required * Utilize and navigate across clinical software applications to assign medical codes or complete reviews * Will be monitored and mentored to achieve removal of apprentice classification when appropriate 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 (or higher) * Coding Certification from AAPC or AHIMA Professional Coding Association: (CPC-A) * 3+ years of coding experience in family medicine * Advanced level of proficiency with ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines * Advanced level of knowledge of medical terminology, disease process and anatomy and physiology * Must be task oriented and able to meet designated deadlines and productivity standards Preferred Qualifications: * Previous Revenue Cycle experience working denials * All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. 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. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN

**$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS** 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.** We're focused on improving the health of our members, enhancing our operational effectiveness and reinforcing our reputation for high - quality health services. As **Senior Inpatient Facility Certified Medical Coder** you will provide coding services directly to providers. You'll play a key part in healing the health system by making sure our high standards for documentation processes are being met. This is a virtual, remote, position that requires candidates to be highly organized, self-starters, and well-versed in technical applications. Previous success in a remote environment is preferred. We offer 4 weeks of training. The hours during training will be 8:00 AM - 5:00 PM Monday-Friday. Training will be conducted virtually from your home. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Identify appropriate assignment of ICD - 10 - CM and ICD - 10 - PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC / MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility + Abstract additional data elements during the Chart Review process when coding, as needed + Adhere to the ethical standards of coding as established by AAPC and / or AHIMA + Adhere to and maintain required levels of performance in both coding quality and productivity as established by Optum360 + Provide documentation feedback to providers and query physicians when appropriate + Maintain up-to-date Coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, etc. + Participate in coding department meetings and educational events + Review and maintain a record of charts coded, held, and / or missing **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* 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) + Professional coder certification with credentialing from AHIMA and/or AAPC (RHIA, RHIT, CCS, CCS-P CPC, OR CPC-H) to be maintained annually + 3+ years of Acute Care inpatient medical coding experience (hospital, facility, etc.) + 2+ years of experience working in a Level 2 (or higher) trauma center and/or teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding + 2+ years of ICD - 10 (CM & PCS) and DRG coding experience + Ability to pass all pre-employment requirements including, but not limited to, drug screening, background check, and coding **Preferred Qualifications:** + 2+ years of outpatient facility coding experience + Experience working in a Level 1 Trauma center + Experience with OSHPD reporting + Experience with various encoder systems (eCAC, 3M, EPIC) + Ability to use a personal computer in a Windows environment, including Microsoft Excel (create, edit, save, and send spreadsheets) and EMR systems + Ability to work the weekly schedule (40 hours / week) with the opportunity to choose between Tuesday - Saturday OR Sunday - Thursday including the flexibility to work occasional overtime and 1 weekend day based on business needs *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. ****PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.** 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. 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. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #GREEN

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.** Under direction of the Coding Manager, the primary responsibility of the **Medical Coder** is to ensure that codes representing current International Classification of Diseases, 9th Revision (ICD-9) or 10th Revision (ICD-10), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) accurately reflect documented services by applying a demonstrated knowledge of anatomy, physiology and medical terminology as well as compliant coding rules and regulations, including medical necessity and modifiers. Additionally, the Medical Coder serves as the key resource to the Chief and Administrative Director and/or Manager regarding coding changes affecting assigned clinical areas, ongoing coding reviews of providers, and trends associated with coding utilization and optimization, denial management, reimbursement, and customer services issues. The Medical Coder is ultimately responsible for efficient charge capture and reconciliation processes (electronic or paper), knowing and meeting expected targets at sufficient accuracy rates as measured by Transaction Editing System (TES) edits, claim action report volumes, and denials. The Medical Coder will identify potential compliance concerns and/or barriers toward timely completion of all tasks to the Coding Manager and will endeavor to work in collaboration with colleagues in Coding, Clinical Departments, Health Information Management, Information Technology, and Finance toward viable solutions. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** The following section contains representative examples of work that will be performed in positions allocated to this classification. Bassett Healthcare is a dynamic organization, and the environment can be fluid. Roles and responsibilities can often be expanded to accommodate changing patient or organizational needs and conditions as well as to tap into skills and talents of employees. Accordingly, employees may be asked to perform duties that are outside the specific functions that are listed. + Charge Capture + Review charge capture documents, paper or electronic, for completeness and accuracy + Reconcile collection of charges to daily census report or schedules depending on place of service + Accurately indicate and link all ICD-10 diagnosis codes, procedure codes and modifiers on the charge document + Prepare daily charge capture documents according to Bassett policies and procedures + Process all pre-billing edits daily and complete each edit within 2 business days + Ensure charges are posted within the following timelines: 4 days from date of service for Outpatient services and 7 days from date of service for Inpatient services by monitoring Lag Time Reports and working with practitioners and associated staff responsible for charge capture to meet those goals + Denial Management + Process denials daily ensuring all requested timelines are met + Ensure procedure and ICD-10 codes reflect documentation + Customer Service + Respond to customer service questions and report recurring issues to management + Work and communicate in a positive, cooperative manner with patients and their families when resolving customer service issues based on management observation and/or patient feedback + Competency + Attend all staff meetings + Maintain current Coding Certification and active membership in the local AAPC chapter, including participation in local events and meetings + Have a good working knowledge of all hospital computer systems and coding tools available to assist with correct coding. This includes Epic's Electronic Health Record application, MedAssets CodeCorrect application, and other department specific clinical/coding applications, e.g. CodeRyte + Keep abreast of coding changes and reimbursement reporting requirements and raise concerns to Coding Manager for resolution + Review and implement changes to departmental/site clinic sheets and charge documents to reflect current ICD-9 or ICD-10 in October, HCPCS and CPT's in January + Abide by Standards of Ethical Coding as set forth by the AAPC or AHIMA (depending on certification) and adhere to Official Coding Guidelines as set forth by CMS and the OIG + Coding Review and Reimbursement Resource + Conduct annual and focused reviews + Use interpersonal skills effectively to build and maintain cooperative working relationships with all levels and departments within the organization + Based on management requests, assists with the orientation, skill development and mentoring of employees new to the coding function + Provide education to all providers within a given specialty based on coding trends and will conduct new provider orientation + Performs similar or related duties as requested or directed + Performs other duties as requested and observed by supervisor or manager 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) + Professional coder certification with credentialing from AHIMA and/or AAPC (RHIA, RHIT, CCS, CCS-P CPC, OR CPC-H) to be maintained annually + 3+ years of experience in Professional Services Surgery Coding (Plastics & Dermatology) + 3+ years of experience working with CPT, HCPCS, ICD-10 codes, anatomy and physiology and medical terminology + 3+ years of experience working with coding rules and regulations for issues regarding medical record documentation, compliance and reimbursement, including medical necessity, claims denials, bundling issues and charge capture **Telecommuting Requirements:** + Required to have a dedicated work area established that is separated from other living areas and provides information privacy + Ability to keep all company sensitive documents secure (if applicable) + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service **Physical Requirements:** + The position involves extensive work at the computer station *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 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. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #GREEN #RPOLinkedin

Explore opportunities with Shared Services, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As a Coding Specialist, you will review medical record documentation submitted by clinicians and subsequently assign the proper International Classification of Disease numerical codes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Review medical records and assign codes + Follow official coding guidelines per CMS and ICD rules + Ensure documentation supports codes + Consult clinicians for clarification + Educate and maintain positive communication with clinicians + Follow workflow processes to maintain productivity standards 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:** + Clinician or a Registered Health Information Administrator (RHIA) or be certified as a Home Care Specialist - Diagnosis (HCS-D) + Successfully pass the HCS-D certification exam within 90 days of employment and maintain HCS-D certification annually **Preferred Qualifications:** + 1+ years of professional work experience + Effective Verbal and Communication *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Explore opportunities with Shared Services, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As a Coding Specialist, you will review medical record documentation submitted by clinicians and subsequently assign the proper International Classification of Disease numerical codes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Review medical records and assign codes * Follow official coding guidelines per CMS and ICD rules * Ensure documentation supports codes * Consult clinicians for clarification * Educate and maintain positive communication with clinicians * Follow workflow processes to maintain productivity standards 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: * Clinician or a Registered Health Information Administrator (RHIA) or be certified as a Home Care Specialist - Diagnosis (HCS-D) * Successfully pass the HCS-D certification exam within 90 days of employment and maintain HCS-D certification annually Preferred Qualifications: * 1+ years of professional work experience * Effective Verbal and Communication * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

**Explore opportunities at Atrius Health** , part of the Optum family of businesses. We're an innovative health care leader and multi-specialty group practice, delivering an effective, connected system of care for adult and pediatric patients at 28 practice locations in eastern Massachusetts. Our entire team of providers (physicians, AP/NPs and ancillary clinicians) works collaboratively with a value-based philosophy within our group practice as well as with hospitals, rehab and nursing facilities. Be part of our vision to transform care and improve lives by building trust, understanding and shared decision-making with every patient. Join us and discover the meaning behind **Caring. Connecting. Growing together.** As the Certified Medical Coder, you will ensure accurate coding of surgical services using CPT-4 and ICD-9/ICD-10, aligned with federal and insurance regulations. Review and interpret operative and pathology reports to validate diagnosis and procedure coding. Identify and recommend documentation improvements based on CMS standards to optimize reimbursement. As well as entering coding data into electronic medical records and serve as a resource for facility coding issues. Stay current with billing/coding updates and maintain certification through continuing education. **Primary Responsibilities:** + Ensure accurate coding of surgical services using CPT-4 and ICD-9/ICD-10, aligned with federal and insurance regulations + Review and interpret operative and pathology reports to validate diagnosis and procedure coding + Identify and recommend documentation improvements based on CMS standards to optimize reimbursement + Enter coding data into electronic medical records and serve as a resource for facility coding issues + Stay current with billing/coding updates and maintain certification through continuing education 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:** + 3+ years of surgical facility coding experience + Thorough knowledge of medical terminology and ICD-9/ICD-10 and CPT4 coding + Understanding both the medical and business side of healthcare operations + Demonstrated ability to multi-task in a fast-paced environment + Proven excellent verbal and written communication skills + Proven detail oriented + Proven solid computer and office skills including phone, keyboard, computer and computer applications, MSOffice, Internet, and E-mail + Proven excellent problem-solving ability + Proven good interpersonal skills **Preferred Qualification:** + 2 - 4 year degree in healthcare or related field 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _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._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Explore opportunities at Atrius Health, part of the Optum family of businesses. We're an innovative health care leader and multi-specialty group practice, delivering an effective, connected system of care for adult and pediatric patients at 28 practice locations in eastern Massachusetts. Our entire team of providers (physicians, AP/NPs and ancillary clinicians) works collaboratively with a value-based philosophy within our group practice as well as with hospitals, rehab and nursing facilities. Be part of our vision to transform care and improve lives by building trust, understanding and shared decision-making with every patient. Join us and discover the meaning behind Caring. Connecting. Growing together. As the Certified Medical Coder, you will ensure accurate coding of surgical services using CPT-4 and ICD-9/ICD-10, aligned with federal and insurance regulations. Review and interpret operative and pathology reports to validate diagnosis and procedure coding. Identify and recommend documentation improvements based on CMS standards to optimize reimbursement. As well as entering coding data into electronic medical records and serve as a resource for facility coding issues. Stay current with billing/coding updates and maintain certification through continuing education. Primary Responsibilities: * Ensure accurate coding of surgical services using CPT-4 and ICD-9/ICD-10, aligned with federal and insurance regulations * Review and interpret operative and pathology reports to validate diagnosis and procedure coding * Identify and recommend documentation improvements based on CMS standards to optimize reimbursement * Enter coding data into electronic medical records and serve as a resource for facility coding issues * Stay current with billing/coding updates and maintain certification through continuing education 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: * 3+ years of surgical facility coding experience * Thorough knowledge of medical terminology and ICD-9/ICD-10 and CPT4 coding * Understanding both the medical and business side of healthcare operations * Demonstrated ability to multi-task in a fast-paced environment * Proven excellent verbal and written communication skills * Proven detail oriented * Proven solid computer and office skills including phone, keyboard, computer and computer applications, MSOffice, Internet, and E-mail * Proven excellent problem-solving ability * Proven good interpersonal skills Preferred Qualification: * 2 - 4 year degree in healthcare or related field 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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.** Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member-centric approach to care. As a Certified Sr. (IP) Acute Edits Medical Coder you will determine and record the correct medical codes for all treatments and health services. Ensuring proper records is just one way your work will impact on the health and wellness of our members on a huge scale. Who are we? We're **Optum360** . We're a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of **UnitedHealth Group** , we'll leverage our compassion, our talent, our resources, and experience to bring financial clarity and a full suite of revenue management services to health care providers nationwide. As a **Certified Sr. (IP) Acute Edits Medical Coder** you will work remotely to correct CCI, MUE, and Medical Necessity Edits on accounts of all patient types in addition to periodic coding. You will ensure that all coding assignments are accurate according to coding policies and based on the documentation provided in the medical record. Using a thorough knowledge of coding policies and procedures as well as medical terminology and technology, you will be responsible for providing documentation feedback to physicians under the direction of the Coding Operations Manager or Quality Management personnel. **Schedule: This** position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given business need, to work occasionally overtime or weekends. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Identify appropriate assignment of ICD-10-CM and ICD-10-PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC/MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility + Identify appropriate assignments of CPT and ICD-10 Codes for outpatient surgery, observation, emergency, and ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility + Understand the Medicare Ambulatory Payment Classification (APC) codes + Abstract additional data elements during the Chart Review process when coding, as needed + Adhere to the ethical standards of coding as established by AAPC and/or AHIMA + Adhere to and maintain required levels of performance in both coding quality and productivity as established by Optum360 + Provide documentation feedback to providers and query physicians when appropriate + Maintain up-to-date Coding knowledge by reviewing materials disseminated/recommended by the QM Manager, Coding Operations Managers, and Director of Coding/Quality Management, etc. + Participate in coding department meetings and educational events + Review and maintain a record of charts coded, held, and/or missing + Additional responsibilities as identified by manager 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) + Professional coder certification with credentialing from AHIMA and/or AAPC (CCS, RHIA, RHIT, CIC, ROCC, CPC, COC, CPC-P) to be maintained annually + 3+ years of recent inpatient medical coding experience with ICD-10-CM/PCS & DRG (hospital, facility, etc.) + 2+ years of recent working experience with OCE, MUE and NCCI classification and reimbursement structures + Intermediate level of proficiency with a PC in a Windows environment, including MS Excel and EMR systems + Intermediate level of experience working in a level I trauma center and/or teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding **Preferred Qualifications:** + Experience with OSHPD reporting + Experience with various encoder systems (eCAC,3M, EPIC) + Intermediate level of proficiency with Microsoft Excel *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. 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. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #GREEN