Outpatient Facility Coder or Reimbursement Specialist - Remote

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.This individual will function as a coding, billing, reimbursement, and regulatory policy subject matter expert. Applicant must apply expertise in current coding systems (ICD-10/CPT/HCPCS), outpatient facility reimbursement methodologies, compliance with HIPAA requirements and operational expertise to provide up-to-date and accurate content for a range of products including print, electronic and data file formats.You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:

Review and update content related to UB-04 revenue coding, including but not limited to:

Type of bill codes (TOB)

Revenue codes

Condition codes

Occurrence codes

CPT/HCPCS codes

Review and update content related to OPPS regulatory guidance and OCE guidance

Work closely with developers/IT personnel to complete root cause analysis and required enhancements for all data maintained by the team.

Review and update content related to CPT/HCPCS classification, including:

Guidelines and conventions

Appropriate use of modifiers

Work in conjunction with other team members to ensure an accuracy rate of 100%

Demonstrate initiative and judgement in performance of job responsibilities

Be able to multitask and know when to re-prioritize assignments/projects based on content effective dates and regulatory update processes

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:

Have, and maintain, at least one of the following professional certifications:

RHIT

RHIA

CCS

CPC

5+ years of coding experience in charge master and/or hospital (facility) coding/billing

Ability to write defensible regulatory and/or coding content utilizing recognized sources such as Official Coding Guidelines, AHA Coding Clinic, CPT Assistant, CMS transmittals and internet only manuals

Thorough understanding of revenue codes, payment and status indicators, type of bill, ICD-10 Coding, HCPCS/CPT coding systems, and Medicare Hospital Outpatient Prospective Payment System (OPPS)

Preferred qualifications:

Experience with Risk Adjustment (HCC) regulatory processes, coding, and risk score trending

Experience working with large amounts of data

Experience with implementation of business requirements

Experience with Encoder tools

Experience with Microsoft office tools

Careers with Optum . Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.