Talent.com
This job offer is not available in your country.
Senior Medical Coding Analyst

Senior Medical Coding Analyst

UnitedHealth GroupHyderabad, Telangana, India
6 hours ago
Job description

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Coder Functions :

  • Verifying the coding of the diagnosis, evaluation and management, procedures, modifiers or other codes required for the completeness and accuracy of the record
  • Review, examine and verify component parts of medical records
  • Ensure completeness and accuracy of billed service
  • Consistency and completeness of coding using established CMS criteria and regulations
  • Authorized signatures and patient identification to ensure all documents contain sufficient documentation to support the diagnosis and treatment administered, and the results obtained are adequately described
  • Review diagnosis, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs with International Classification of Diseases (ICD10), Current Procedural Terminology (CPT), Heath Care Financing
  • Administration Common Procedure Coding Systems (HCPCS - all levels, and any other coding classification systems that may be required)

Primary Responsibilities :

  • Validate the claim denial reason and logic in our internal claim processing platforms and confirm that the logic is correctly applied according to CMS coding policies, including, but not limited to : NCCI Policy, NCD / LCD, Medicare Claim Processing Manual
  • From a Part C perspective, we cannot use UHC payment policies unless there is a direct CMS source of truth to support
  • Search for information in cases where the coding is complex or unusual
  • Interpret appeal, validate claim processing, and tie that denial of service directly to a CMS policy that is both applicable to the date of service and provider specialty, to determine if the denial should be overturned or upheld
  • Ensure all the provider's arguments are reviewed and resolved with a concise timeline narrative / explanation including the direct sourcing to support the denial / uphold (if applicable)
  • 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 regard 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
  • Ability to navigate & understand functionality :

  • COSMOS / Facets
  • Claim forms
  • ATS
  • CMS.gov
  • Outpatient Code Editor
  • CES
  • SAM edit
  • Required Qualifications :

  • Bachelor's Degree or 5+ years of technical writing experience
  • 5+ years Coding and auditing experience E&M, CPT, HCPCS, Preferable Denial Coding
  • Exposure in client interactions
  • Experience with spreadsheet and word processing management, such as Excel and Word
  • Demonstrated ability to manage and prioritize deliverables
  • Proven excellent verbal and written communication skills
  • Proven organizational skills with ability to be flexible and work with ambiguity
  • Work with minimal guidance; seek guidance on only the most complex tasks
  • Proven attention to detail
  • Preferred Qualifications :

  • Coding Certification (examples : CPC, CCS / CCS-P, RHIT, RHIA, etc.) or willing to obtain upon hire
  • Experience with standard healthcare industry code sets such as E&M, CPT, HCPCS, ICD10, etc.
  • Knowledge on Denials and Medicare & Medicaid policies and CMS Guidelines :
  • At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

    Create a job alert for this search

    Senior Analyst • Hyderabad, Telangana, India

    Related jobs
    • Promoted
    Walk In Drive - Medical Coding - IP DRG & ED Facility

    Walk In Drive - Medical Coding - IP DRG & ED Facility

    Thryve Digital Health LLPHyderabad, Telangana, India
    Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation sol...Show moreLast updated: 7 days ago
    • Promoted
    • New!
    Medical Coding-Reputed Medical Industry-Hyderabad,Telangana, India-6LPA-Harshala

    Medical Coding-Reputed Medical Industry-Hyderabad,Telangana, India-6LPA-Harshala

    Seven ConsultancyHyderabad, Telangana, India
    Excellent opportunity for MBBS,BDS,BSMS,BHMS in Medical Coding Process for our Healthcare Services Division.Initial file review for identifying merits. Subjective review and analysis to identify ins...Show moreLast updated: 6 hours ago
    • Promoted
    • New!
    RCM Coding Specialist

    RCM Coding Specialist

    ModMedHyderabad, Telangana, India
    We are united in our mission to make a positive impact on healthcare.South Florida Business Journal, Best Places to Work 2024. Fastest-Growing Private Companies in America 2024.Black Book Awards, ra...Show moreLast updated: 6 hours ago
    • Promoted
    Senior Medical Coder- IP-DRG

    Senior Medical Coder- IP-DRG

    Doctus Data Services Private LimitedHyderabad, Telangana, India
    IP DRG Coders : We are hiring experienced, certified Senior Inpatient DRG Medical Coders with extensive knowledge of ICD-10-CM and PCS Coding, and excellent communication skills.Minimum 7 to 10 yea...Show moreLast updated: 29 days ago
    • Promoted
    MedConverge - Manager - Medical Coding - US Healthcare RCM

    MedConverge - Manager - Medical Coding - US Healthcare RCM

    MEDCONVERGE HEALTHCARE SERVICES PRIVATE LIMITEDHyderabad, India
    Position Summary : We are seeking a highly skilled, experienced, and results-driven Manager of Medical Coding to lead and inspire our medical coding...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    RCM AR Analyst

    RCM AR Analyst

    ModMedHyderabad, Telangana, India
    We are united in our mission to make a positive impact on healthcare.South Florida Business Journal, Best Places to Work 2024. Fastest-Growing Private Companies in America 2024.Black Book Awards, ra...Show moreLast updated: 6 hours ago
    • Promoted
    • New!
    Senior Medical Billing Java consult...

    Senior Medical Billing Java consult...

    Anicalls (Pty) LtdHyderabad, Telangana, India
    Experience in working with a Clearing House for submitting and receiving medical claims using EDI formatted files.Experience with claim generation and claim posting processes.Strong Knowledge of OO...Show moreLast updated: 6 hours ago
    • Promoted
    Senior Statistical Programmer

    Senior Statistical Programmer

    EphicacySecunderabad, Telangana, India
    We are seeking a highly skilled Lead Statistical Programmer with expertise in SAS and R programming to support clinical trial data analysis and regulatory submissions.The ideal candidate will a...Show moreLast updated: 9 days ago
    • Promoted
    • New!
    Senior Coding Specialist

    Senior Coding Specialist

    IKS HealthHyderabad, Telangana, India
    Retrieve the correct medical record of a patient, review & validate completeness of documentation along with signatures, orders for diagnostic tests etc. Review and validate and / or assign / modify, pr...Show moreLast updated: 6 hours ago
    • Promoted
    • New!
    Medical Coding Auditor, Compliance

    Medical Coding Auditor, Compliance

    ModMedHyderabad, Telangana, India
    We are united in our mission to make a positive impact on healthcare.South Florida Business Journal, Best Places to Work 2024. Fastest-Growing Private Companies in America 2024.Black Book Awards, ra...Show moreLast updated: 6 hours ago
    • Promoted
    Vice President - Operations - Medical Coding

    Vice President - Operations - Medical Coding

    GeBBS Healthcare SolutionsHyderabad, India
    Job Title : Vice President of Medical Coding Operations Work Location : Mumbai / Hyderabad Department / Vertical : Opera...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Business Analyst - Medical coder

    Business Analyst - Medical coder

    GenpactHyderabad, Telangana, India
    Genpact (NYSE : G) is a global professional services and solutions firm delivering outcomes that shape the future.Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepr...Show moreLast updated: 6 hours ago
    • Promoted
    • New!
    Senior Coding Specialist Auditor

    Senior Coding Specialist Auditor

    IKS HealthHyderabad, Telangana, India
    Retrieval and review of documentation in medical records from various client EMR systems.Verify the completeness of the documentation and coding in accordance with the coding compliance guidelines....Show moreLast updated: 6 hours ago
    • Promoted
    • New!
    Coding Specialist

    Coding Specialist

    IKS HealthHyderabad, Telangana, India
    Profile Description The role requires : .Retrieval and review of documentation in.Documentation analysis for completeness. Assignment of relevant diagnoses,.Retrieve the correct medical record of a.Re...Show moreLast updated: 6 hours ago
    • Promoted
    Senior Data Analyst

    Senior Data Analyst

    RecroHyderabad, Telangana, India
    Proven experience with patient and / or payer data management solutions in the US pharmaceutical market.Microsoft Office suite (PowerPoint, Word). HIPAA-compliant data management experience.Experience...Show moreLast updated: 20 days ago
    • Promoted
    • New!
    ▷ Apply in 3 Minutes : Senior Medical Coder- IP-DRG

    ▷ Apply in 3 Minutes : Senior Medical Coder- IP-DRG

    Doctus Data Services Private LimitedHyderabad, Telangana, India
    IP DRG Coders : We are hiring experienced, certified Senior Inpatient DRG Medical Coders with extensive knowledge of ICD-10-CM and PCS Coding, and excellent communication skills.Minimum 7 to 10 yea...Show moreLast updated: less than 1 hour ago
    • Promoted
    Assistant Manager / Manager / Senior Manager - Medical Coding

    Assistant Manager / Manager / Senior Manager - Medical Coding

    AXIS SERVICESHyderabad, India
    Medical Coding (AM | Manager | Sr.Manager) 7 - 12 years - 15-30 Lacs P.Mumbai (All Areas), Hyderabad, Aurangabad - Higher Positions for Medical Coding (AM | Manager | Sr.Manag...Show moreLast updated: 7 days ago
    • Promoted
    • New!
    Medical Coding Analyst

    Medical Coding Analyst

    UnitedHealth GroupHyderabad, Telangana, India
    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 connect...Show moreLast updated: 6 hours ago