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Claims Analyst / Inpatient Coder - Telecommute

UnitedHealth Group

Atlanta, GA
Job Code:
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Job Details

751051 Claims Analyst Inpatient Coder Telecommute

Claims Analyst / Inpatient Coder - Telecommute (751051)

Position Description

Health care isn't just changing. It's growing more complex every day. Because of this hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. If you're looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) 

Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member-centric approach to care. As an Inpatient Medical Coder you will determine and record the correct medical codes for all treatments and health services. Ensuring proper records is just one way your work will impact the health and wellness of our members on a huge scale. 

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

Primary Responsibilities:
  • coding knowledge to analyze/correct CCI Edits and Medical Necessity accounts
  • Identify appropriate assignment of ICD-10-CM and ICD-10-PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC/MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
  • Identify appropriate assignment of CPT and ICD-10 Codes for outpatient surgery, observation, emergency, and ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
  • Understand the Medicare Ambulatory Payment Classification (APC) codes
  • Abstract additional data elements during the Chart Review process when coding, as needed
  • 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 and productivity as established by Optum360
  • Provide documentation feedback to providers and query physicians when appropriate
  • Maintain up-to-date Coding knowledge by reviewing materials disseminated/recommended by the QM Manager, Coding Operations Managers, and Director of Coding/Quality Management, etc.
  • Participate in coding department meetings and educational events
  • Review and maintain a record of charts coded, held, and/or missing

This is a virtual, remote, position that requires candidates to be highly organized, self-starters, well-versed in technical applications. Previous success in a remote environment is preferred.  The work schedule is flexible. Typically, Sunday through Thursday or Tuesday through Saturday with set hours as established between manager and coder may require weekend and/or holiday coverage to meet business needs as well as the possibility of mandatory overtime.

Required Qualifications:
  • Professional coder certification with credentialing from AHIMA and/or AAPC (CCS, RHIA, RHIT, CIC, ROCC, CPC, COC, CPC-P) to be maintained annually
  • HS Diploma or GED
  • 3+ years of Inpatient medical coding experience (hospital, facility, etc.)
  • Intermediate knowledge of OCE, MUE and NCCI classification and reimbursement structures
  • Experience working in a level I trauma center and/or teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding
  • Must have ICD-10 and DRG coding experience
  • Ability to use a PC in a Windows environment, including MS Excel and EMR systems
Preferred Qualifications:
  • Experience with OSHPD reporting
  • Experience with various encoder systems (eCAC,3M, EPIC)
  • Intermediate level of experience with Microsoft Excel
  • 2+ years of Outpatient Facility Surgery coding experience

If you’re eager to bring your contribution to a new level every day, today.  Here’s your opportunity to do your life’s best work.(sm)

*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.



Job Keywords: Inpatient Coder, facility, hospital, DRG, ICD-10, RHIA, RHIT, CCS, Telecommute, Coding editor, analyst, telecommuter, virtual

Job Details

  • Contest Number751051
  • Job TitleClaims Analyst / Inpatient Coder - Telecommute
  • Job FamilyMedical and Clinical Operations
  • Business SegmentOptumInsight

Job Location Information

  • Atlanta, GA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusNon-exempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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