Explore jobs
Find specific jobs
Explore careers
Explore professions
Best companies
Explore companies
Medical Records Clerk jobs at Humana - 27 jobs
Medical Coding Auditor
Humana
Medical records clerk job at Humana
**Become a part of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Where you Come In** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. As a Medical Coding Auditor for the Hospital Outpatient/APC Coding Team you will: + Verify and ensure the accuracy, completeness, specificity and appropriateness of procedure codes based on services rendered + Review medical documentation for clinical indicators to ensure specific procedures meet clinical criteria and correct coding guidelines specific to Ambulatory Payment Classification (APC) and Hospital Outpatient Facility coding + Utilize encoders and various coding resources + Perform CPT/HCPCS Procedure reviews + Conduct peer reviews to ensure compliance with coding guidelines and provide reports as needed + Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release of information + Maintain current working knowledge of ICD-10 and CPT coding guidelines, government regulation and protocols + Complete appropriate system(s) entry regarding claim/encounter information + Support and participate in process and quality improvement initiatives **What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education. **Use your skills to make an impact** **WORK STYLE:** 100% work at home/remote **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week-- some flexibility might be possible, depending on business needs **Required Qualifications - What it takes to Succeed** + CPC, COC, CCS, ROCC, RHIA, or RHIT Certification with a minimum of 3 years post-certification experience + Minimum of 3 years post certification experience Outpatient Specialty Surgeries and Procedures + Strong knowledge of CPT/HCPCS coding + Experience reading & coding from operative reports + Chemotherapy/Therapeutic Infusion experience + Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information + Strong attention to detail, can work independently and determine appropriate course of action, & ability to handle multiple priorities + Comfortable working in a production-based work environment + Ability to work independently and manage workload + Strong written and verbal communication skills; strong analytical, organizational and time management skills + Working knowledge of Microsoft Office Programs (Word, Excel) **Preferred Qualifications** + 5+ years prior coding experience + Minimum of 3 years post certification experience reading and interpreting claims + Outpatient facility auditing experience + Experience with coding/auditing Radiology, Gastroenterology, Urinary, Musculoskeletal, Integumentary, Anesthesia, General Surgery, Cardiology, Respiratory, Infusion, Interventional Radiology + Ambulatory Payment Classification (APC) coding experience + Radiation Oncology coding experience + Experience in prospective payment methodologies + Experience with the Claims Life Cycle including Accounts Receivable + 3M Coder software experience **Additional Information** **Work at Home Requirements** - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************$59.3k-80.9k yearly 13d agoMedical Coding Auditor
Humana
Medical records clerk job at Humana
**Become a part of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. + Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines + Utilize encoders and various coding resources + Perform CPT Procedure reviews + Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release of information + Maintain current working knowledge of ICD-10 and CPT coding principles, government regulation, protocols **Use your skills to make an impact** **WORK STYLE:** Remote/Work at home; minimal travel may be required for onsite meetings. **WORK HOURS:** Associates will work on EST, regardless of where the associate resides. Work hours can vary, slightly, but all associates start between 6AM-9AM EST. Some flexibility is available, depending on business needs. **Required Qualifications** + Minimum of 3+ years post certification experience Outpatient Specialty Surgeries and Procedures for Physicians + RHIA, RHIT, CCS, CPC, or COC Certification + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + **STRONGLY PREFERRED** : Experience with coding/auditing multispecialty surgical procedures. + Experience with coding/auditing Professional Inpatient Claims + Experience in Select Coder, 3M + Experience with the Claims Life Cycle **Additional Information** **Work at Home Requirements** - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-17-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************$59.3k-80.9k yearly 5d agoInpatient Coder - Remote
Tenet Healthcare Corporation
Frisco, TX jobs
Responsible for assigning diagnostic and procedural codes to inpatient charts using ICD-10-CM and ICD-10-PCS 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. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Coding: Reviews medical records for the determination of accurate code assignment of all documented diagnoses and procedures in accordance with Official Coding Guidelines. Adheres to Standards of Ethical Coding (AHIMA). * Abstracting: Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition. * Coding Quality: Demonstrates consistency in achieving or exceeding 95.5% coding accuracy in the selection of principal and secondary diagnoses ((including DRG, MCC & CC, SOI/ROM)) and procedures. Demonstrates accuracy and consistency in abstracting elements defined by per facility. * Coder Productivity: Meets and/or exceeds Conifer's inpatient coding productivity guidelines * Physician Queries: Demonstrates strong skills in creating appropriate and compliant physician retrospective coding queries. * Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and ICD-10-PCS coding. Completes mandatory coding education as assigned. Quarterly review of AHA Coding Clinic. Attends all required coding operations conference calls. * DNFB: Reviews held accounts daily for resolution in support of coding DNFB performance. Communicates barriers to leaders ( physician queries, missing documentation, second level review, DRG reconciliation, etc.) for appropriate follow-up and 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. * Strong knowledge of MS-DRG and APR DRG classification and reimbursement structures * Proficient at writing AHIMA compliant physician queries * Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness and elevating concerns to the appropriate manager * Proficient in researching and responding to Business Office questions related to coding and/or payer-specific coding guidelines. * Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency * Works collaboratively with CDI, Quality and other facility leadership * Functional knowledge of facility EMR, encoder, CDI tool and other support software 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 preferred to perform the job. * One to three years experience performing inpatient coding in acute care setting required * High school graduate or equivalent is required * Associate or Bachelor's Degree in Health Information, Nursing, or other related field preferred. Years of coding experience would be considered in lieu of educational requirements. CERTIFICATES, LICENSES, REGISTRATIONS * Required: AHIMA RHIT or RHIA or AAPC CCS 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 if appropriate 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: $27.30-$40.95 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. **********$27.3-41 hourly 60d+ agoEdit Senior Coder - Remote
Tenet Healthcare Corporation
Frisco, TX jobs
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. **********$24.8-37.2 hourly 32d agoHIM Coder 3, PRN
Community Health System
Remote
Remote ~ California Opportunities for you! Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek Free Continuing Education and certification Tuition reimbursement, education programs and scholarships Vacation time starts building on Day 1, and builds with your seniority Free money toward retirement with a 403(b) and 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. Learn more on our Benefits page. 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! Qualifications Education: High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate Completion of courses in Medical Terminology, Anatomy and Physiology Experience: 5 years of recent inpatient coding experience in an acute care setting Proficient in ICD-10-CM/PCS and CPT-4 coding, DRG and APRDRG assignment Licenses and Certifications CCS - Certified Coding Specialist Disclaimers • Pay ranges listed are an estimate and subject to change. • If any bonuses are noted, they are only applicable to external hires meeting criteria.$44k-72k yearly est. Auto-Apply 60d+ agoInpatient Corporate Coder - Remote based in the US
Tenet Healthcare Corporation
Dallas, TX jobs
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. 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: * High school graduate or equivalent is required * 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: * Associate or Bachelor's Degree in Health Information, Nursing, or other related field preferred. Years of coding experience would be considered in lieu of educational requirements. * 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. 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 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. #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. **********$26.4-39 hourly 5d agoPRN Inpatient Corporate Coder - Remote based in the US
Tenet Healthcare Corporation
Dallas, TX jobs
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. Benefits The following benefits are available, subject to employment status: * Medical, dental, vision, disability, AD&D, and life insurance * Paid time off (vacation & sick leave) * Discretionary 401k 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. #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. **********$26.4-39 hourly 41d agoOutpatient Coder II - Remote
Tenet Healthcare Corporation
Frisco, TX jobs
Responsible for assigning diagnostic and procedural codes to patient charts of moderate to high complexity 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. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Coding: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). * Abstracting: Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition. * Coding Quality: Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures. Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by per facility. * Goal: Average coding quality standard of =>95% accuracy per monitoring period. * Does not meet = * Meets => 95% accuracy * Exceeds =>95.01% accuracy * Coding Labor Productivity: Meets and/or exceeds Conifer's coding productivity guidelines. * Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding. Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-10-CM and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls * Communicates and resolves coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up and 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. * Proficient in outpatient diagnosis coding guidelines * Proficient in CPT/HCPCS code assignment including Evaluation & Management facility coding guidelines * Ability to establish and maintain effective working relationships as required by the duties of the position * Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness and elevating concerns to the appropriate manager * Ability to establish and maintain effective working relationships as required by the duties of the position * Ability to concentrate and accomplish tasks with explicit accuracy * Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency * Functional knowledge of facility EMR, encoder and other support software 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 preferred to perform the job. * One year of experience performing medical record coding in acute care setting preferred * High school graduate or equivalent is required * Completion of basic coding course (academic, seminar, workshop or facility-based), including medical terminology and basic anatomy and physiology, or an equivalent combination of education and experience also required CERTIFICATES, LICENSES, REGISTRATIONS * Required: AHIMA or AAPC 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. * Must be able to work in sitting position, use computer and answer telephone * Ability to travel * 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 Work Environment * Hospital Work Environment 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: $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. **********$20.5-30.8 hourly 60d+ agoPhysician Services Coding Specialist II - Remote Radiology
Tenet Healthcare Corporation
Frisco, TX jobs
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. **********$20.5-30.8 hourly 27d agoRemote Coder III-IP Coder
Community Health Systems
Remote
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$41k-63k yearly est. Auto-Apply 60d+ agoCoding Specialist (HCS-D Certification Required) - Remote
Unitedhealth Group
Shreveport, LA jobs
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._$20-35.7 hourly 39d agoSurgical Profee Medical Coder - National Remote
Unitedhealth Group Inc.
Albany, NY jobs
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$20-35.7 hourly 27d agoSurgical Profee Medical Coder - Plastics & Dermatology - National Remote
Unitedhealth Group
Albany, NY jobs
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$20-35.7 hourly 60d+ agoSenior Inpatient Facility Certified Medical Coder
Unitedhealth Group
Minneapolis, MN jobs
**$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 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 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) + 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$23.4-41.8 hourly 56d agoCoding Specialist - HCS-D Certification Required - Remote
Unitedhealth Group Inc.
Houston, TX jobs
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.$20-35.7 hourly 27d agoCoding Specialist - HCS-D Certification Required - Remote
Unitedhealth Group
Houston, TX jobs
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._$20-35.7 hourly 37d agoCertified Surgical Medical Coder - Remote- New England Resident Only- Atrius Health
Unitedhealth Group Inc.
Newton, MA jobs
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.$20-35.7 hourly 38d agoCertified Surgical Medical Coder - Remote- New England Resident Only- Atrius Health
Unitedhealth Group
Newton, MA jobs
**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._$20-35.7 hourly 37d agoSenior IP Acute Edits Medical Coder
Unitedhealth Group Inc.
Eden Prairie, MN jobs
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$23.4-41.8 hourly 27d agoSenior IP Acute Edits Medical Coder
Unitedhealth Group
Eden Prairie, MN jobs
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$23.4-41.8 hourly 60d+ ago
Looking for a job?
Let Zippia find it for you.
Learn more about Humana jobs
- Reviews
