Profee Auditor at Optum

Opportunities at Owensboro Health, in strategic partnership with Optum. Our team of talented people works to improve the health outcomes of the communities we serve. As an Optum employee, you will provide support to the Owensboro health account. They are a nonprofit system with over 200 providers at more than 20 locations, 3 outpatient facilities, a certified medical fitness facility, a surgical weight loss center and the Mitchell Memorial Cancer Center. We are continually searching for people like you to help us provide the most innovative health care services. Join a team that will make you feel valued and discover the meaning behind: Caring. Connecting. Growing together.

This position is full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 4:30pm. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

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

Primary Responsibilities

• Assesses and interprets the needs of the Ambulatory Coding Team by prioritizing work to meet deadlines. This can include assisting with coding duties and managing work queues
• Identifies solutions to non-standard edits, workflows and issues
• Solves complex questions and conducts analysis of trends to provide education for the coding staff and clients including physicians/providers
• Provides detailed education to the Coding Team and acts as a resource to others
• Apply expert coding knowledge to professional coding and billing initiatives and inquiries
• Identify appropriate assignment of ICD-10-CM, CPT, and HCPCS II Codes for physician services, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Adhere to the ethical standards of coding as established by AAPC and/or AHIMA
• Adhere to and maintain required levels of performance in both coding quality 95% and productivity as established by Optum360
• Understand the federal coding register and ensure guidelines are used and followed appropriately
• Understanding of the appeal process with knowledge how to speak to denial and/or appeals
• Provide documentation feedback to providers and query physicians when appropriate
• Maintain up-to-date Coding knowledge by reviewing materials disseminated/recommended by Compliance, Coding Operations, etc.
• Participate in coding department meetings and educational events
• Strong knowledge of coding clinics and how to obtain education information
• Assist in rebills as appropriate
• Other duties at the discretion of the VP & management
  
  

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 higher)
• Professional coder certification with credentialing from AHIMA and/or AAPC (CPC, CCS-P, RHIA, RHIT) to be maintained annually
• 3+ years of experience with physician medical coding, including surgical and/or specialty specific coding in a multi-specialty physician group
• Intermediate level of proficiency with a PC in a Windows environment, including Microsoft Excel (filter, sort, edit)
• Ability to work full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 4:30pm. It may be necessary, given the business need, to work occasional overtime
• Must be 18 years of age OR older
  
  

Preferred Qualifications

• 3+ years of experience in E/M coding (both IP and OP), surgical and specialty specific coding
• Experience auditing charts in a professional coding environment
• Experience providing physician/coding education
• Experience with various systems (EPIC, Encoder Pro)
• Expert level of proficiency with coding guidance to physicians, practitioners and coders as needed
• Intermediate level of knowledge of OCE, MUE and NCCI classification and reimbursement structure
• 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 $28.27 to $50.48 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.

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