Outpatient Medical Coder Edits Specialist
3 days ago
Deliver high-quality medical coding services for outpatient facilities, ensuring accurate and compliant coding practices. Collaborate with healthcare professionals to provide exceptional patient care and contribute to the advancement of healthcare equity.
Key Responsibilities:- Assign accurate CPT and ICD-10 codes for outpatient surgeries, observations, and complex cases
- Apply coding knowledge to analyze and correct CCI Edits and Medical Necessity accounts
- Understand Medicare Ambulatory Payment Classification (APC) codes and abstract additional data elements during chart review
- Adhere to ethical coding standards and maintain required performance levels in coding quality and productivity
- Provide documentation feedback to providers and query physicians when necessary
- Maintain up-to-date coding knowledge and participate in coding department meetings and educational events
- High School Diploma/GED or higher
- Professional coder certification with AHIMA and/or AAPC credentialing
- 2+ years of outpatient facility coding experience
- 2+ years of experience with ICD-10
- 1+ year of experience with LCD, NCD, Medical Necessity, and Modifier Edits
- Ability to use a PC in a Windows environment, including Microsoft Excel and EMR systems
- Experience with complex cardiac catheterizations and interventional radiology (CVIR/IVR)
- Experience with various encoder systems (eCAC, 3M, EPIC)
- Intermediate level of experience with Microsoft Excel
- Experience with OSHPD reporting
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.
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