Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Primary Responsibilities:

• Be able to implement all the updates of AMA guidelines, AHA guidelines, and CMS guidelines
• Be able to review and analyse medical records and add/modify CPT codes for minor surgical procedures, vaccines, and laboratory CPT codes as per documentation
• Be able to extract and code various screening CPT codes and HCPCS codes from the documentation
• Be able to check NCCI edits and LCD & NCD coverage determinations and modify ICD-10-CM codes, CPT codes, and modifiers accordingly
• Be an ideal team player who can work in a large group and provide inputs to the team for betterment of the team in terms of quality and productivity
• Under general supervision, organizes and prioritizes all work to ensure that records are coded, and edits are resolved in a timeframe that will assure compliance with regulatory and client guidelines
• Adherence with confidentiality and maintains security of systems
• Compliance with HIPAA policies and procedures for confidentiality of all patient records
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Graduate
• Certified coder through AAPC or AHIMA
• Certifications accepted include CPC, CCS, CIC and COC – Anyone
• Current coding certifications and must provide proof of certification with valid certification identification number during interview or Offer process
• Sound knowledge in Medical Terminology, Human Anatomy and Physiology
• Knowledge of security of systems and associated policies and procedures for maintaining the security of the data contained within the systems
• Basic understanding of the ED/EM levels based on MDM and appending modifiers to CPT codes as per NCCI edits and CPT guidelines
• Proficient in ICD-10-CM, CPT, and HCPCS guidelines

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