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Job Details

UnitedHealth Group

Coding Specialist - US Telecommute (100279545)

Equipment/Technology Specialist

Equipment and Facilities Specialist



Worcester, Massachusetts, United States

Opportunities with Reliant Medical Group. When you join Reliant, you’ll be part of a community-based, multi-specialty, physician-led medical group. Primary care and specialist providers work collaboratively on a common purpose: improving the quality, cost and experience of health care. With the resources of a global health organization - Optum - behind us, we’re at the forefront of value-based care. Supported by a patient-centric business model – your integrated care teams focus on the best patient care, rather than volume. Providers practice at the peak of their license - focusing effective, quality care and plans. Through innovation and superior care management, we support a focus on patients and on your wellbeing. Discover a place where you can help shape the future of health care and do your life’s best work.(sm)

This role is responsible for procedure and diagnostic coding of professional charges. Works closely with clinical department physicians and staff to ensure accurate and compliant coding and maximization of revenue through initial coding and appeals of payer rejections relating to coding.

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

Primary Responsibilities:

  • Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other providers of professional billing
  • Prepares, reviews, and transmits claims using billing software, including electronic and paper claim processing
  • Contact’s providers or their representatives regarding inappropriate, incomplete or unclear coding
  • Searches for information in cases where the coding is complex or unusual. Forwards unresolved coding questions to manager for review and comment
  • Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations
  • Follows up on outstanding coding related receivables following standard Revenue Operations policy/procedure/process and based upon payer filing deadlines
  • Initiates refunds when appropriate for all third-party insurance receipts in accordance with governmental and insurance contract agreements
  • Ensures appropriateness of payer rejections and denials for coding related reasons
  • Contact’s payers/governmental agencies regarding coding related denials and appeals as appropriate following established Revenue Operations policy/procedure/process
  • Notifies manager of any coding denial trends
  • Responds to coding related inquiries from providers and support staff and others as requested
  • Must keep current of governmental and other payor coding and reimbursement rules and requirements
  • Completes insurance and demographic registration updates as needed in conjunction with Registration Specialists
  • Reports accurate productivity and other data as requested
  • Maintains productivity, quality standards and processing timelines as established by Revenue Operations Metrics
  • Ensures compliance with payer filing deadlines
  • Cooperates fully with all governmental and third-party insurer audits
  • Adheres to all governmental and third-party compliance issues as directed
  • Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
  • Complies with established departmental policies, procedures, and objectives
  • Enhances professional growth and development through educational programs, seminars, etc.
  • Attends a variety of meetings, conferences, and seminars as required or directed
  • Performs other similar and related duties as required or directed
  • Regular, reliable and predicable attendance is required

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 graduate
  • Certified Coder - Billing and Coding - 1 year experience needed
  • Certified or Eligible for certification: CPC, CCS-P, CPC-A
  • Demonstrated knowledge and experience in ICD-10, CPT and HCPCS coding or successful completion of related college course
  • Medical terminology certificate or demonstrated knowledge
  • Demonstrated knowledge of third-party billing
  • Must show proficiency in current billing software within six (6) months

Preferred Qualifications:

  • Excellent organizational and communication skills
  • Ability to work independently and as part of a team
  • Must demonstrate a professional and courteous manner when interacting with physicians/providers, clinical department staff and co-workers

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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)

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

Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $17.12 to $30.34. The hourly range for Connecticut/Nevada residents is $18.80 to $33.44. 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 and its affiliated medical practices are 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 and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Coding Specialist, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote