Coder \/ Auditor II - Telecommute

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

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Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

Optum is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Coder-Auditor, II demonstrates proficiency in all aspects of outpatient coding. The Coder-Auditor, II performs medical chart audits for evaluation, management, and documentation. This role also interfaces and disseminates audit results to clinicians and management. This role qualifies for remote status.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
  • Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer
  • Represents the Company in a professional manner, following all Company policies and procedures.
  • Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • Complies with all aspects of Coding and Corporate Compliance standards
  • Abides by all ethical standards and adheres to official coding guidelines
  • Conducts physician chart audits to identify incorrect coding, prepares reports of findings and any compliance issues
  • Reports coding patterns identified within the audit process to the Manager, and identifies corrective measures to compliance problems
  • Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials
  • Interacts with physicians and center administrators regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Provides second-level review of billing performances to ensure compliance with legal and procedural policies to ensure adherence to regulations prohibiting unbundling and other questionable practices
  • Enhances professional growth and development through in-service meetings, educational programs, conferences, etc.
  • Assists in the preparation of training materials
  • Maintains confidentiality
  • Performs related work and projects as required
  • Performs other duties as assigned
  • Must have consistent, punctual and reliable attendance


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 equivalent
  • Certified Coder (based on specific organizations) or equivalent
  • 2+ years of coding experience in a healthcare environment
  • Excellent understanding of medical terminology, disease process and anatomy and physiology
  • Excellent understanding of ICD-10-CM coding classification
  • Excellent understanding of CPT coding within a healthcare environment

Preferred Qualifications:
  • Experience with Risk and Fee for Service Coding
  • Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) and Medicare Advantage reimbursement


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado Residents Only: The salary range for Colorado residents is $43,200 to $76,700. 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

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Job Keywords: Certified Coder, Risk Coding, FFS Coding, Primary Care Coding, Telecommute, Remote, Work from Home

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