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Coding Operations Support Analyst

Optum

National remote role supporting coding operations for hospital-based and professional services.

Review charge inquiries and resolve Service Under Review (SUR) and Medical Necessity held accounts to support accurate claims processing and reimbursement.

Assign and validate ICD-10-CM, CPT, HCPCS, and modifier codes for outpatient surgery, observation, emergency department, ancillary, and professional hospital-based services.

Analyze coding-related failed medical edits, review medical record documentation, identify documentation gaps, submit provider queries, and support coding education and departmental processes.

Apply Medicare reimbursement methodologies and abstract clinical and demographic data as needed.

Requirements & Qualifications

Qualifications

  • High school diploma or GED
  • Active AHIMA or AAPC coding credential: CCS, CIC, CPC, COC, CPC-P, RHIT, RHIA, or equivalent
  • 3+ years of experience in acute care hospital, outpatient, or professional-fee coding environments
  • Knowledge of medical terminology and coding guidelines
  • Experience reviewing and resolving coding-related reimbursement issues
  • Proficiency with Microsoft business applications
  • Working knowledge of Medicare reimbursement methodologies, including APC, OCE, MUE, and NCCI edits
  • Proficiency with electronic medical records and encoder applications
  • Must be 18 years of age or older

Preferred

  • Experience with observation services, emergency medicine, surgery, cardiology, interventional radiology, orthopedics, neurology, or professional clinic coding
  • Experience with 3M/HDM, Cener, or similar encoder and EMR systems
  • Experience with coding quality reviews, claim edit resolution, and denial prevention
  • Knowledge of Rural Health Clinic coding
Benefits & Perks

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase plan
  • 401(k) contribution
  • 4 to 6 weeks of on-the-job training
  • Flexible weekday schedule
  • Remote work flexibility

Location

Dallas, Texas, US

Employment Type

Full-time

Experience Level

Intermediate Level

Remote work allowed

Yes

Posted

1 week ago

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