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Medical Coder jobs at UnitedHealth Group

- 26 jobs
  • Senior Medical Coder

    Unitedhealth Group 4.6company rating

    Medical coder job at UnitedHealth Group

    Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** The **Senior Medical Coder** performs concurrent review of FFS coding rules in Athena, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. **Schedule** : Monday to Friday, 6 AM- 6 PM PST, 40 hours/week **Location** : Remote - Nationwide You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines + Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes + Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes + Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information + Follow up with providers as necessary when responses to queries are not provided on a timely basis + Utilize medical coding software programs or reference materials to identify appropriate codes + Apply post-query response to make final determinations + Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations + Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters) + Resolve medical coding edits or denials in relation to code assignment + Provide information or respond to questions from medical coding quality audits + Demonstrate basic knowledge of the impact of coding decisions on revenue cycle + Attain and/or maintain relevant professional certifications and continuing education seminars as required + Utilize and navigate across clinical software applications to assign medical codes or complete reviews + Will be monitored and mentored to achieve removal of apprentice classification when appropriate You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma/GED (or higher) + Coding Certification from AAPC or AHIMA Professional Coding Association: (CPC-A) + 3+ years of coding experience in family medicine + Advanced level of proficiency with ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines + Advanced level of knowledge of medical terminology, disease process and anatomy and physiology + Must be task oriented and able to meet designated deadlines and productivity standards **Preferred Qualifications:** + Previous Revenue Cycle experience working denials *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #GREEN
    $23.4-41.8 hourly 52d ago
  • Senior Medical Coder

    Unitedhealth Group 4.6company rating

    Medical coder job at UnitedHealth Group

    Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** The **Senior Medical Coder** performs concurrent review of FFS coding rules in Athena, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. **Schedule** : Monday to Friday, 6 AM- 6 PM PST, 40 hours/week **Location** : Remote - Nationwide You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines + Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes + Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes + Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information + Follow up with providers as necessary when responses to queries are not provided on a timely basis + Utilize medical coding software programs or reference materials to identify appropriate codes + Apply post-query response to make final determinations + Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations + Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters) + Resolve medical coding edits or denials in relation to code assignment + Provide information or respond to questions from medical coding quality audits + Demonstrate basic knowledge of the impact of coding decisions on revenue cycle + Attain and/or maintain relevant professional certifications and continuing education seminars as required + Utilize and navigate across clinical software applications to assign medical codes or complete reviews + Will be monitored and mentored to achieve removal of apprentice classification when appropriate You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma/GED (or higher) + Coding Certification from AAPC or AHIMA Professional Coding Association: (CPC-A) + 3+ years of coding experience in family medicine + Advanced level of proficiency with ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines + Advanced level of knowledge of medical terminology, disease process and anatomy and physiology + Must be task oriented and able to meet designated deadlines and productivity standards **Preferred Qualifications:** + Previous Revenue Cycle experience working denials *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #GREEN
    $23.4-41.8 hourly 52d ago
  • Sr Certified Medical Coder RN

    Centene 4.5company rating

    Remote

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be willing to travel to NYC twice a year for required meetings. Position Purpose: The focus of this position is to establish processes to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review. Analyze moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance. Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. Provide regular reports on project status and progress; report project results to identify coding improvement opportunities. Collaborate with other business units to identify and implement process efficiency and quality improvement practices. Work with IT resources to implement system efficiencies and configuration enhancements to improve claims processing operations. Apply Coding Guidelines as described in the ICD-10 Coding Manual. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: RN Degree. One year experience preferred in hospital inpatient coding. Nursing experience in managed care organization or acute care hospital. One year of experience in a clinical setting or acute care hospital; RN, PA, MD, APRN, DO or MBBS license required. Coding Credential Required: Valid/Current CPC Certification, through APPC preferred or CIC through AAPC or CCS through AHIMA; RHIA/RHIT Credentials-Preferred. Pay Range: $68,700.00 - $123,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $68.7k-123.7k yearly Auto-Apply 53d ago
  • Data Analyst IV Medical Economics

    Centene 4.5company rating

    Remote

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management Develop reports and deliverables and make recommendations to management Model data using MS Excel, Access, SQL, and/or other data ware house analytical tools Assist management in driving business decisions based on data Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis Assist with training and mentoring other Data Analysts Assist with determining work load and related activities for other Data Analysts Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 5+ years of experience working with large databases, data verification, and data management or 3+ years IT experience. Healthcare analytics experience preferred. Experience with table creation and indexing, query optimization, and utilization of stored procedures. Working knowledge of SQL/querying languages. Experience with table creation and indexing, query optimization, and utilization of stored procedures. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $86k-154.7k yearly Auto-Apply 60d+ ago
  • Inpatient Medical Coding Auditor

    Humana 4.8company rating

    Columbus, OH jobs

    **Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient 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 and appropriate diagnosis related group (DRG) 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. **Use your skills to make an impact** + Additional Job Description **WORK STYLE:** Remote/work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week, scheduled between 6AM-6PM. Some flexibility might be possible, depending on business needs. **Required Qualifications | What it takes to Succeed** - RHIA, RHIT or CCS Certification (should have held at least one of these qualifications for 4 years) - MS-DRG coding/auditing experience - Experience reading and interpreting claims - Experience in performing inpatient coding reviews/ audits in health insurance and/or hospital settings - Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel - Strong attention to detail - Can work independently and determine appropriate course of action - Ability to handle multiple priorities - Capacity to maintain confidentiality - Excellent communication skills both written and verbal **Preferred Qualifications** - Experience in APR DRG coding/auditing - Experience in Financial Recovery - Experience in a fast paced, metric driven operational setting **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. $71,100 - $97,800 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: 12-25-2040 **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 ***************************************************************************
    $71.1k-97.8k yearly 4d ago
  • Inpatient Medical Coding Auditor

    Humana 4.8company rating

    Columbus, OH jobs

    **Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient 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 and appropriate diagnosis related group (DRG) 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. **Use your skills to make an impact** **WORK STYLE:** Remote/work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week, scheduled between 6AM-6PM. Some flexibility might be possible, depending on business needs. **Required Qualifications | What it takes to Succeed** - RHIA, RHIT or CCS Certification (should have held at least one of these qualifications for 4 years) - MS-DRG coding/auditing experience - Experience reading and interpreting claims - Experience in performing inpatient coding reviews/ audits in health insurance and/or hospital settings - Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel - Strong attention to detail - Can work independently and determine appropriate course of action - Ability to handle multiple priorities - Capacity to maintain confidentiality - Excellent communication skills both written and verbal **Preferred Qualifications** - Experience in APR DRG coding/auditing - Experience in Financial Recovery - Experience in a fast paced, metric driven operational setting **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. $71,100 - $97,800 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: 12-25-2040 **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 ***************************************************************************
    $71.1k-97.8k yearly 4d ago
  • Inpatient Coder - Remote

    Tenet Healthcare Corporation 4.5company rating

    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 37d ago
  • Medical Management Auditor

    Centene 4.5company rating

    Remote

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes Develop and maintain the audit process and tools related to: authorizations, appeals, quality events, and case management in CCMS; interrater reliability related to InterQual; and data entry into the credentialing subsystem Develop and maintain the audit schedule Audit staff as outlined in the system auditing policies Train audit staff at the health plan in the use of audit process and tools Facilitate compliance with the auditing process Act as a consultant related to system auditing to others in the unit, department and health plan Work with staff to identify and resolve authorization load error report system problems Coordinate auditing outcomes with the Trainer to identify, develop and publish corrective actions/educational material related to audit errors Coordinate auditing outcomes and system maintenance with the Sr. Clinical Systems Specialist to resolve or enhance clinical systems Performs other duties as assigned Complies with all policies and standards ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN MISSOURI***Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience. Education/Experience: Bachelor's degree in related field or equivalent experience. 3+ years of related experience. For Home State Health Plan only: State unrestricted license as Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse (RN), or Licensed Practical Nurse (LPN) Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $55.1k-99k yearly Auto-Apply 10d ago
  • Edit Senior Coder - Remote

    Tenet Healthcare Corporation 4.5company rating

    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 8d ago
  • Data Analyst III Medical Economics

    Centene 4.5company rating

    Remote

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes. Interpret and analyze data from multiple sources including claims, provider, member, and encounters data. Identify and assess the business impact of trends Develop, maintain, and troubleshoot complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools Contribute to the planning and execution of large-scale projects with limited direction from leadership Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines and thrive in a demanding, quickly changing environment Demonstrate a sense of ownership over projects and ask probing questions to understand the business value of tasks Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products Partner cross-functionally at all levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners Independently engage with customers and business partners to gather requirements and validate results Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required Provide technical guidance to junior analysts Education/Experience: Bachelor's degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 4+ years of experience working with large databases, data verification, and data management or 2+ years of IT experience. Healthcare analytics experience preferred. Working knowledge of SQL/querying languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools including Microsoft PowerBI. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. Pay Range: $68,700.00 - $123,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $68.7k-123.7k yearly Auto-Apply 23d ago
  • Inpatient Corporate Coder - Remote based in the US

    Tenet Healthcare Corporation 4.5company rating

    Dallas, TX jobs

    * 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. #LI-MJ1 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. Required: * Associates or higher-level degree in a Health Information Management discipline. * 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.). * 1-3 years inpatient coding experience. * Skilled and working knowledge of MS Office suite. * Strong technical background and electronic medical record experience. 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, 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 17d ago
  • PRN Inpatient Corporate Coder - Remote based in the US

    Tenet Healthcare Corporation 4.5company rating

    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 17d ago
  • Outpatient Coder II - Remote

    Tenet Healthcare Corporation 4.5company rating

    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 37d ago
  • Physician Services Coding Specialist II - Remote Production Denials

    Tenet Healthcare Corporation 4.5company rating

    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 3d ago
  • Physician Services Coding Specialist II - Remote Radiology

    Tenet Healthcare Corporation 4.5company rating

    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 3d ago
  • Senior Inpatient Facility Certified Medical Coder

    Unitedhealth Group 4.6company rating

    Medical coder job at UnitedHealth Group

    **$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 32d ago
  • Certified Surgical Medical Coder - Remote- New England Resident Only- Atrius Health

    Unitedhealth Group Inc. 4.6company rating

    Medical coder job at UnitedHealth Group

    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 14d ago
  • Certified Surgical Medical Coder - Remote- New England Resident Only- Atrius Health

    Unitedhealth Group 4.6company rating

    Medical coder job at UnitedHealth Group

    **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 14d ago
  • Field Operations Data Analyst, Shockwave Medical

    Johnson & Johnson 4.7company rating

    Santa Clara, CA jobs

    At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more at ******************* Job Function: Sales Enablement Job Sub Function: Customer Success Management Job Category: Professional All Job Posting Locations: Santa Clara, California, United States of America Job Description: Johnson & Johnson is hiring for a Field Operations Data Analyst - Shockwave Medical to join our team. The position is FULLY REMOTE and can sit anywhere in the US. At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow and profoundly impact health for humanity. Learn more at *******************/. Fueled by innovation at the intersection of biology and technology, we're developing the next generation of smarter, less invasive, more personalized treatments. Ready to join a team that's pioneering the development and commercialization of Intravascular Lithotripsy (IVL) to treat complex calcified cardiovascular disease. Our Shockwave Medical portfolio aims to establish a new standard of care for medical device treatment of atherosclerotic cardiovascular disease through its differentiated and proprietary local delivery of sonic pressure waves for the treatment of calcified plaque. The Field Operations Data Analyst works with the worldwide sales organization to bring process improvement and efficiency to inventory practices. Through strong communication, robust problem solving, a natural curiosity to ask 'why', and recommending solutions. He/she will contribute to the growth and evolution of data-informed decisions and action related to field operations. Analysis & Reporting * Identify and recommend areas of opportunity within field sales and communicate with key decision leaders within the company. * Effectively communicate complex information to field sales force and commercial operations individuals. * Create, monitor, and improve reports in PowerBI using metrics generated in Salesforce, Oracle, and other systems. * Find the best / most simple solution while providing maximum benefit to our supported units. * Work with large data sets, glean intelligence from data, draw conclusions, and enabling recommendations to key stakeholder groups. Field Inventory Team * Manage inventory allocation and disposition of sales personnel trunk stock and/or customer consignment within the United States and Internationally. * Incorporate automation and reporting to daily field inventory practices. * Communicate with field sales personnel in a constructive manner to find solutions to individualized problem sets. * Communicate with cross functional teams to ensure timely completion of tasks ensuring field sales personnel have necessary equipment to provide ideal care to patient population. Requirements * Bachelor's Degree in business/technical field * At least 1-3 years of directly related work experience. * Ability to problem solve and recognize potential issues before they impact the business. * Ability to work in ambiguity. * Ability to effectively collaborate across various stakeholders and teams. * Strong communication skills with personnel that do not have an analytical background. * Ability to design solutions to complex problems. * Courage to challenge existing ways of thinking. * Adaptable with capacity to learn new systems on the fly and continue to evolve as the business incorporates new tools. * Able to make decisions that positively impact the business. * Understanding of building reporting/visualization tools such as PowerBI or Tableau * Understanding of automation processes. Thirst for self-improvement and personal growth. * Fluent in English. Nice to Have but Not Required Experience * Ability to efficiently read in data, analyze, and present data using Python, R, or SQL * Experience in a related field (life sciences, pharmaceutical, medical device, biotech) * Unique background that brings different perspective to a team. * Fluent in Japanese, Chinese, German, Spanish, Portuguese, French, or Italian. Johnson & Johnson is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, protected veteran status or other characteristics protected by federal, state or local law. We actively seek qualified candidates who are protected veterans and individuals with disabilities as defined under VEVRAA and Section 503 of the Rehabilitation Act. Johnson & Johnson is committed to providing an interview process that is inclusive of our applicants' needs. If you are an individual with a disability and would like to request an accommodation, please contact us via *******************/contact-us/careers or contact AskGS to be directed to your accommodation resource. Required Skills: Data Governance, Data Quality, Fact-Based Decision Making, Organizing, Problem Solving Preferred Skills: Analytical Reasoning, Business Behavior, Cross-Functional Collaboration, Customer Acquisition Strategy, Customer Centricity, Customer Effort Score, Customer Engagement, Customer Intelligence, Customer Journey Analysis, Customer Journey Mapping, Customer Retentions, Customer Success Management (CSM), Execution Focus, Industry Analysis, Sales Enablement, Sales Support, Service Excellence The anticipated base pay range for this position is : US : $65,000 - $104,650 / Bay Area: $75,000 - $120,750 Additional Description for Pay Transparency: Subject to the terms of their respective plans, employees and/or eligible dependents are eligible to participate in the following Company sponsored employee benefit programs: medical, dental, vision, life insurance, short- and long-term disability, business accident insurance, and group legal insurance. Subject to the terms of their respective plans, employees are eligible to participate in the Company's consolidated retirement plan (pension) and savings plan (401(k)). This position is eligible to participate in the Company's long-term incentive program. Subject to the terms of their respective policies and date of hire, Employees are eligible for the following time off benefits: Vacation -120 hours per calendar year Sick time - 40 hours per calendar year; for employees who reside in the State of Washington -56 hours per calendar year Holiday pay, including Floating Holidays -13 days per calendar year Work, Personal and Family Time - up to 40 hours per calendar year Parental Leave - 480 hours within one year of the birth/adoption/foster care of a child Condolence Leave - 30 days for an immediate family member: 5 days for an extended family member Caregiver Leave - 10 days Volunteer Leave - 4 days Military Spouse Time-Off - 80 hours Additional information can be found through the link below. *********************************************
    $75k-120.8k yearly Auto-Apply 23d ago
  • Senior IP Acute Edits Medical Coder

    Unitedhealth Group 4.6company rating

    Medical coder job at UnitedHealth Group

    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

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