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Job Details

UnitedHealth Group

Fee for Service Medical Coder - Telecommute


Medical Director



Golden, Colorado, United States

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

Review documentation to assure proper application of ICD-10 coding guidelines and policies. Application of appropriate CPT, CPTII, HCPCS, and modifiers necessary for accurate charge submission and reimbursement. Maintain defined charge submission turnaround times. Query providers for documentation clarification. Communicate with providers and clinic staff on a regular basis regarding documentation, coding and billing related issues.

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

Primary Responsibilities:

  • Reviews provider documentation, diagnoses and charge codes for assigned providers or sites to ensure proper ICD-10CM, CPT, CPTII, HCPCS and modifiers are applied for appropriate reimbursement
  • Query providers or clinic staff as necessary for clarification of documentation or lack thereof as it pertains to proper application of ICD-10 diagnosis codes, E&M leveling and procedure code assignment
  • Codes for FFS and Commercial ACO population; ensures proper documentation and designation of HCC codes for ACO members
  • Reviews additional chart details and documentation as necessary to ensure proper diagnoses and procedure codes are applied; including reviewing orders, pathology, radiology, labs and other test results
  • Will work out of Touchworks EHR,and Allscripts PM applications
  • Conducts physician chart audits for E&M and diagnosis coding as requested (includes research and presentation of finding and correct coding principles)
  • Expected to maintain a coding accuracy level of 96%
  • Maintains turnaround times as defined by Manager
  • Assists billing office staff with claims denials and corrections for re-billing purposes as needed
  • Conducts training sessions for physicians on relevant topics or updates, such as documentation guidelines, Medicare/Medicaid regulations, and coding requirements
  • Maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10 CM, CPT, and HCPCS II materials
  • Enhances professional growth and development through in-service meetings, educational programs, conferences, etc.
  • Utilize coding tools provided, ICD-10, CPT, HCPCS books, and Encoder pro to perform accurate coding
  • Meet productivity expectations and provide Manger with weekly productivity report
  • Follow all CDO and OptumCare policies and coding guidelines
  • Maintains strictest confidentiality
  • Performs other miscellaneous duties as required

Work Environment/Schedule:

  • Remote/Telecommute. Local travel is possible, contact with physicians, administrators and staff as necessary.

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:

  • H.S. Diploma or equivalent with knowledge of medical terminology
  • Anatomy and physiology or other clinical knowledge of disease process
  • Certified Professional Coder (CPC) certificate
  • 3+ years of experience in physician coding and/or reimbursement activities
  • Solid presentation skills and previous evaluation & management medical chart audit experience
  • Extensive knowledge and understanding of ICD-10 CM, CPT, HCPCS and coding guidelines
  • Knowledge of encoder software and other coding applications/tools
  • Solid knowledge and understanding of regulatory compliance
  • Extensive knowledge and understanding of general coding principles
  • Familiarity with quality care measures and associated CPT II codes
  • Familiar with third party fee profiles, claim edits and reimbursement requirements
  • Skill in exercising initiative, judgment, discretion, and decision-making to achieve organizational objectives
  • Aptitude for establishing and maintaining effective working relationships with physicians and clinic staff
  • Must be computer literate
  • Ability to make simple mathematical computations
  • Proficient with Microsoft Office applications (Outlook, Word, Excel)
  • Possesses working knowledge of commercial insurance and Medicare/Medicaid
  • Able to utilize electronic health record systems and other billing technologies
  • Understands HIPAA and other relevant regulations affecting patient information and billing practices

Preferred Qualifications:

  • Skill in problem-identification and problem-resolution
  • Must be detail-oriented and able to meet targeted deadlines
  • Solid communication skills (interpersonal, verbal and written, presentation)
  • Solid organizational and analytical thinking skills
  • Demonstrates critical thinking skills, and ability to interpret, assess, and evaluate provider documentation
  • Self-motivated and able to work independently without close supervision

Equipment/Tools Used:

  • Laptop with Citrix environment, Allscripts TW, Allscripts PM and MS Office software

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, 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)

Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $21.68 to $38.56. The hourly range for Connecticut / Nevada residents is $23.94 to $42.40. 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 Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.