Outpatient Medical Coder Edits Specialist

3 days ago


Phoenix, Arizona, United States Optum Full time
Optum Medical Coder Role

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
Requirements:
  • 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
Preferred Qualifications:
  • 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.


  • Cerner Coder

    3 weeks ago


    Phoenix, Arizona, United States Jobot Consulting Full time

    Job SummaryWe are seeking a skilled Cerner Coder to join our team at Jobot Consulting. As a Cerner Coder, you will be responsible for accurately abstracting, reconciling, and reviewing procedure and physician documentation to code and enter into electronic medical billing systems.Key ResponsibilitiesSupport Soarian Financials Billing Edits and Billing...

  • Medical Coder

    4 weeks ago


    Phoenix, Arizona, United States Health Advocates Network Full time

    Health Advocates Network E/M Coder Job OpportunityWe are seeking an experienced E/M Coder to join our team at Health Advocates Network, a leading healthcare organization with a deep commitment to caring. As an E/M Coder, you will play a critical role in ensuring the accuracy and quality of our coding and billing processes.Key Responsibilities:Abstract coding...

  • Medical Coder

    4 weeks ago


    Phoenix, Arizona, United States Health Advocates Network Full time

    Health Advocates Network E/M Coder Job OpportunityWe are seeking an experienced E/M Coder to join our team at Health Advocates Network, a leading healthcare organization with a deep commitment to caring. As an E/M Coder, you will play a critical role in ensuring the accuracy and quality of our coding and billing processes.Key Responsibilities:Abstract coding...


  • Phoenix, Arizona, United States The LaSalle Group Full time

    Medical Coding SpecialistWe are seeking a skilled Medical Coding Specialist to join our team at The LaSalle Group. As a Medical Coding Specialist, you will be responsible for reviewing inpatient and outpatient records to assign accurate ICD-10, CPT, and HCPCS codes. Your attention to detail and analytical skills will ensure compliance with industry standards...


  • Phoenix, Arizona, United States iMemories Full time

    Job Title: Digital Content Editing SpecialistWe are seeking a highly skilled Digital Content Editing Specialist to join our team at iMemories. As a Digital Content Editing Specialist, you will be responsible for editing and converting digital media content for our clients.Job DescriptionKey Responsibilities:Edit and convert digital media content for clients,...


  • Phoenix, Arizona, United States LaSalle Network Full time

    Medical Coding Expert WantedWe are seeking a skilled Medical Coding Specialist to join our team at LaSalle Network. As a key member of our healthcare revenue cycle team, you will be responsible for reviewing inpatient and outpatient records to assign accurate ICD-10, CPT, and HCPCS codes.Key Responsibilities:Review medical records to ensure accurate coding...

  • E/M Coder Position

    3 weeks ago


    Phoenix, Arizona, United States Health Advocates Network Full time

    Job Title: E/M CoderWe are seeking an experienced E/M Coder to join our team at Health Advocates Network, Inc. As an E/M Coder, you will play a crucial role in abstracting coding from medical records to ensure accurate and timely billing.Responsibilities:Abstract coding from medical records to ensure accurate and timely billingAnalyze and evaluate data...


  • Phoenix, Arizona, United States LaSalle Network Full time

    Medical Coding and Compliance SpecialistWe are seeking a skilled Medical Coding and Compliance Specialist to join our team at LaSalle Network. As a Medical Coding and Compliance Specialist, you will be responsible for reviewing inpatient and outpatient records to assign accurate ICD-10, CPT, and HCPCS codes. You will also ensure compliance with industry...


  • Phoenix, Arizona, United States Patterson Schlotterer Medical Group Full time

    Job DescriptionWe are seeking a highly skilled Pediatric Medical Billing Specialist to join our team at Patterson Schlotterer Medical Group. As a key member of our staff, you will be responsible for overseeing the daily processing and submission of claims from our practice management system to the clearinghouse and third-party payors.Your duties will...


  • Phoenix, Arizona, United States LaSalle Network Full time

    Medical Coding Expert WantedWe're seeking a skilled Medical Coding Expert to join our team at LaSalle Network. As a key member of our healthcare revenue cycle team, you'll play a crucial role in ensuring accurate and compliant coding practices.Responsibilities:Review medical records to assign accurate ICD-10, CPT, and HCPCS codesEnsure compliance with...


  • Phoenix, Arizona, United States Triwest Healthcare Full time

    Job SummaryWe are seeking a highly skilled Inpatient Facility Coder to join our team at TriWest Healthcare Alliance. As a key member of our coding team, you will be responsible for conducting coding reviews of prior authorization requests, retrospective medical claims review, and coding review for inpatient claims. Your expertise in ICD-10-CM, ICD-10-PCS,...


  • Phoenix, Arizona, United States Triwest Healthcare Full time

    Job SummaryWe are seeking a highly skilled and experienced Senior Inpatient Facility Coding Specialist to join our team at TriWest Healthcare Alliance. As a key member of our coding team, you will be responsible for conducting retrospective medical claims review for coding and pricing determinations, as well as coding review for inpatient claims.Key...


  • Phoenix, Arizona, United States Triwest Healthcare Full time

    Job SummaryWe are seeking a highly skilled and experienced Senior Inpatient Facility Coder to join our team at TriWest Healthcare Alliance. As a key member of our coding team, you will be responsible for conducting retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims.Key...


  • Phoenix, Arizona, United States PSG Global Solutions Careers Full time

    Job SummaryWe are seeking a highly skilled HEDIS Coder/Abstractor to join our team at PSG Global Solutions Careers. As a key member of our team, you will be responsible for reviewing medical records and documenting clinical data for HEDIS reporting. Your expertise in medical coding and quality improvement will be essential in ensuring the accuracy and...


  • Phoenix, Arizona, United States Triwest Healthcare Full time

    Job SummaryTriWest Healthcare Alliance is seeking a highly skilled Senior Inpatient Facility Coder to join our team. As a key member of our coding team, you will be responsible for conducting retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims.Key Responsibilities Serve as a subject...


  • Phoenix, Arizona, United States Barrow Brain & Spine Full time

    Job Title: Certified Medical CoderAt Barrow Brain and Spine, we are seeking a highly skilled Certified Medical Coder to join our team. As a Certified Medical Coder, you will play a critical role in ensuring the accuracy and efficiency of our reimbursement processes.Job Summary:The Certified Medical Coder will be responsible for accurately assigning ICD-10,...


  • Phoenix, Arizona, United States Triwest Healthcare Full time

    Job SummaryWe are seeking a highly skilled and experienced Senior Inpatient Facility Coder to join our team at TriWest Healthcare Alliance. As a key member of our coding team, you will be responsible for conducting retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims.Key...


  • Phoenix, Arizona, United States Triwest Healthcare Full time

    Job SummaryWe are seeking a highly skilled Inpatient Facility Coder to join our team at TriWest Healthcare Alliance. As a key member of our coding team, you will be responsible for conducting coding reviews of prior authorization requests, retrospective medical claims review, and coding review for inpatient claims. Your expertise in ICD-10-CM, ICD-10-PCS,...


  • Phoenix, Arizona, United States UnitedHealth Group Full time

    Unlock Your Potential as a Senior Inpatient Medical CoderAt UnitedHealth Group, we're committed to delivering high-quality health services that improve the lives of our members. As a Senior Inpatient Medical Coder, you'll play a vital role in ensuring the accuracy and integrity of our coding processes.Key Responsibilities:Assign ICD-10 CM and ICD-10 PCS...


  • Phoenix, Arizona, United States Barrow Brain & Spine Full time

    Job Title: Certified Medical CoderJob Summary:The Certified Medical Coder is responsible for accurately assigning ICD-10, CPT, and HCPCS codes to hospital consultation services provided by BBS medical providers. This role ensures proper coding of patient encounters to support compliant and efficient reimbursement processes, adhering to payer guidelines and...