Senior Outpatient Medical Coder (CCI
About the position As a Senior Outpatient Medical Coder at Optum, you will play a crucial role in ensuring the accuracy and compliance of medical coding for outpatient services. This position allows for remote work, providing flexibility while you engage in vital tasks that directly impact health outcomes. Your primary responsibility will be to correct CCI, MUE, and Medical Necessity Edits on accounts across various patient types, ensuring that all coding assignments adhere to established coding policies and are based on the documentation provided in the medical record. You will utilize your extensive knowledge of coding policies, medical terminology, and technology to provide feedback to physicians regarding documentation under the guidance of the Coding Operations Manager or Quality Management personnel. In this role, you will be responsible for determining and recording the correct medical codes for all treatments and health services, which is essential for maintaining accurate health records. Your work will not only support the operational efficiency of the organization but also enhance the health and wellness of our members on a large scale. You will be expected to maintain high standards of coding quality and productivity, participate in departmental meetings, and stay updated with the latest coding knowledge through continuous education and training. This full-time position requires flexibility to work any of our 8-hour shift schedules from Monday to Friday, with the possibility of occasional overtime and weekend work as needed. You will be rewarded for your performance in an environment that encourages professional growth and development, allowing you to explore various career paths within the organization.
Responsibilities
- Identify appropriate assignment of CPT and ICD-10 Codes for outpatient surgery, observation, emergency, and ancillary services while adhering to official coding guidelines.
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- Understand the Medicare Ambulatory Payment Classification (APC) codes.
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- Abstract additional data elements during the Chart Review process when coding, as needed.
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- Adhere to the ethical standards of coding as established by AAPC and/or AHIMA.
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- Maintain required levels of performance in both coding quality and productivity as established by Optum360.
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- Provide documentation feedback to providers and query physicians when appropriate.
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- Maintain up-to-date coding knowledge by reviewing materials disseminated by management.
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- Participate in coding department meetings and educational events.
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- Review and maintain a record of charts coded, held, and/or missing.
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- Perform additional responsibilities as identified by the manager.
Requirements
- High School Diploma/GED (or higher).
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- Professional coder certification with credentialing from AHIMA and/or AAPC (CCS, RHIA, RHIT, CIC, ROCC, CPC, COC, CPC-P) to be maintained annually.
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- ICD-10 and DRG coding experience.
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- Experience working in a level I trauma center and/or teaching hospital with mastery of complex procedures.
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- Knowledge of OCE, MUE and NCCI classification and reimbursement structures.
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- Ability to use a PC in a Windows environment, including EMR systems.
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- Ability to work any of our 8-hour shift schedules between Monday - Friday, with flexibility for occasional overtime.
Nice-to-haves
- 3+ years of Inpatient medical coding experience (hospital, facility, etc.).
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- Experience with OSHPD reporting.
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- Experience with various encoder systems (eCAC, 3M, EPIC).
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- Intermediate level of proficiency with Microsoft Excel.
Benefits
- Comprehensive benefits package
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- Incentive and recognition programs
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- Equity stock purchase
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- 401k contribution
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- $3,000 sign-on bonus for external applicants
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