Profee Psychiatry Medical Coder – National Remote – Remote No Degree UnitedHealthcare Group

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. Caring. Connecting. Growing together. Under direction of the Coding Manager, the primary responsibility of the Medical Coder is to ensure that codes representing current International Classification of Diseases, 9th Revision (ICD-9) or 10th Revision (ICD-10), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) accurately reflect documented services by applying a demonstrated knowledge of anatomy, physiology and medical terminology as well as compliant coding rules and regulations, including medical necessity and modifiers. Additionally, the Medical Coder serves as the key resource to the Chief and Administrative Director and/or Manager regarding coding changes affecting assigned clinical areas, ongoing coding reviews of providers, and trends associated with coding utilization and optimization, denial management, reimbursement, and customer services issues. The Medical Coder is ultimately responsible for efficient charge capture and reconciliation processes (electronic or paper), knowing and meeting expected targets at sufficient accuracy rates as measured by Transaction Editing System (TES) edits, claim action report volumes, and denials. The Medical Coder will identify potential compliance concerns and/or barriers toward timely completion of all tasks to the Coding Manager and will endeavor to work in collaboration with colleagues in Coding, Clinical Departments, Health Information Management, Information Technology, and Finance toward viable solutions. You’ll enjoy the flexibility to telecommute

• from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities The following section contains representative examples of work that will be performed in positions allocated to this classification. Bassett Healthcare is a dynamic organization, and the environment can be fluid. Roles and responsibilities can often be expanded to accommodate changing patient or organizational needs and conditions as well as to tap into skills and talents of employees. Accordingly, employees may be asked to perform duties that are outside the specific functions that are listed.

• Charge Capture
• Review charge capture documents, paper or electronic, for completeness and accuracy
• Reconcile collection of charges to daily census report or schedules depending on place of service
• Accurately indicate and link all ICD-10 diagnosis codes, procedure codes and modifiers on the charge document
• Prepare daily charge capture documents according to Bassett policies and procedures
• Process all pre-billing edits daily and complete each edit within 2 business days
• Ensure charges are posted within the following timelines: 4 days from date of service for Outpatient services and 7 days from date of service for Inpatient services by monitoring Lag Time Reports and working with practitioners and associated staff responsible for charge capture to meet those goals
• Denial Management
• Process denials daily ensuring all requested timelines are met
• Ensure procedure and ICD-10 codes reflect documentation
• Customer Service
• Respond to customer service questions and report recurring issues to management
• Work and communicate in a positive, cooperative manner with patients and their families when resolving customer service issues based on management observation and/or patient feedback
• Competencies
• Attend all staff meetings
• Maintain current Coding Certification and active membership in local AAPC chapter, including participation in local events and meetings
• Have a good working knowledge of all hospital computer systems and coding tools available to assist with correct coding. This includes Epic’s Electronic Health Record application, Med Assets Code Correct application, and other department specific clinical/coding applications, e.g. Code Ryte
• Keep abreast of coding changes and reimbursement reporting requirements and…

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