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Senior Inpatient Medical Coder - Acute Edits & Denials

Optum

Optum is seeking a Senior Inpatient Medical Coder / Acute Edits and Denials Claims Analyst to work remotely and support acute inpatient hospital coding and claim edit resolution.

In this role, you will correct CCI, Medically Unlikely (MUE), and medical necessity edits, as well as work periodic coding tasks and multiple claim-related work queues. You will ensure inpatient acute hospital coding assignments are accurate and aligned with coding policies and the documentation in the medical record.

You will also query physicians for documentation when needed, support provider feedback, assist with complex unbilled or incomplete records, and help identify opportunities to improve compliance and coding quality. This position involves collaboration with other departments on charge build, documentation requirements, payer workflows, and special projects related to compliance and billing.

Requirements & Qualifications

Required qualifications

  • Associate's degree
  • One of the following credentials required upon hire and maintained annually:
    • RHIA, RHIT, CCS, or CIC
    • Certified Coding Specialist (AHIMA)
    • Certified Inpatient Coder (AAPC)
    • Registered Health Information Technician (AHIMA)
    • Registered Health Information Administrator (AHIMA)
  • 2+ years of coding experience
  • 2+ years of acute care inpatient medical coding experience in a hospital or facility setting

Preferred experience

  • Experience with MS-DRG and APR-DRG assignment
  • Experience identifying secondary diagnoses, including complications and comorbidities
  • Experience with present-on-admission indicators
  • Experience assigning ICD-10-PCS procedure codes
  • Experience with charge and supply codes, EPIC Account Activities, and payer billing workflows is beneficial
Benefits & Perks

Benefits and perks

  • Remote work flexibility within the U.S.
  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase program
  • 401(k) contribution
  • Career development opportunities

Location

Minnesota, US

Employment Type

Full-time

Experience Level

Senior

Remote work allowed

Yes

Posted

3 weeks ago

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