Requisition number: 2402412
Job category: Medical & Clinical Operations
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 Coder II is a member of the Health Information Management Team responsible for ensuring the accuracy and completeness of clinical coding, validating the information in the databases for outcome management and specialty registries, across the entire integrated healthcare system. The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual patient health information records for data retrieval, analysis and claims processing. This position is expected to perform duties in alignment with the mission and policies within the Dignity Health organization, TJC, CMS and other regulatory agencies.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Key Responsibilities:
Assign codes for diagnoses, treatments, and procedures according to the appropriate classification system for ED admissions
Can code ancillary charts if needed
Review provider documentation to determine reason for visit, first listed and secondary diagnosis codes and surgical procedures following official coding guidelines
Provide documentation feedback to providers, as needed
Utilize technical coding principals and APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and CPT codes for procedures
Extract required information from source documentation and enter into encoder and abstracting system
Review documentation to verify and when necessary, correct the patient disposition upon discharge
Prioritize work to ensure timeframe of medical record coding meets established KPI's
Serve as a resource for coding related questions as appropriate
Meet performance and quality standards at the Coder I level
Participate in department meetings and educational events
Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines
Assists with OSHPD correction
Other duties as assigned that have a direct impact on our ability to decrease the DNFB and support Revenue Cycle, including but not limited to charge validation, observation calculations, etc.
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 or equivalent required
Completion of an AHIMA or AAPC accredited coding certification program that includes courses that are critical to coding success such as: Anatomy and physiology, pathophysiology, pharmacology, Anatomy / Physiology, Medical Terminology and ICD-10 and CPT coding courses etc
Have and maintain current coding credential from AHIMA or AAPC (RHIA, RHIT, CCS, CCS-P CPC or CPC-H)
2+ years of coding and abstracting experience or equivalent combination of education and experience required
2+ years of Emergency and Ancillary facility coding experience*
Must have ICD-10 coding experience
Ability to use a PC in a Windows environment, including MS Word and EMR systems
Ability to pass all pre-employment requirements including, but not limited to: drug screening, background check, and coding technical assessment
One year of experience will be waived for those who have attended the Dignity Health Coding Apprenticeship Program.
Preferred Qualifications:
Experience with various Encoder systems (i.e., OptumCAC, Cerner)
Intermediate level of Microsoft Excel
Experience with coding and charge validation
Knowledge, Skills and Abilities:
Analytical / Critical thinking
Problem Solving
Knowledge and application of ICD-10-CM, HCPCS and CPT-4 classification systems
Excellent written and verbal communication skills, including the ability to present ideas and concepts effectively across organizational levels
Knowledge of information privacy laws, access, release of information, and release control technologies
Knowledge of hospital protocols and procedures
Working knowledge of functional relationships between departments within a healthcare or similar environment
Knowledge of TJC, HIPAA, HCFA, Title 22, security principles, guidelines, and standard healthcare practices
Demonstrated competence with personal computers, networks, and Microsoft Office
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $36.00 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
