Registered Nurse Certified Professional Coder

Posted 3 Days Ago
Be an Early Applicant
Dallas, TX, USA
In-Office
92K-164K Annually
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Provide certified coding and clinical expertise to support benefit digitization and coding governance. Develop and maintain standardized code groupings, manage code updates, ensure regulatory compliance, support benefit administration and complex coding requests, and collaborate cross-functionally as the primary coding resource for projects and stakeholders.
Summary Generated by Built In
Requisition Number: 2377170
This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
As the organization accelerates its digital transformation, Benefit Digitization and AI 10.0 efforts are key to improving efficiency, enhancing member and provider experiences, and managing long term costs. To achieve these goals, dedicated roles are needed to design, implement, and manage the digital capabilities that support these initiatives.
This position is for a Certified Coder who will provide coding expertise and clinical support across a wide range of initiatives and processes. This role requires close collaboration with cross-functional teams to ensure alignment with both clinical and business objectives, while supporting the successful execution of projects.
This position is full-time (40 hours/week), Monday - Friday. Employees must work an 8-hour shift during business operating hours of 8:00am - 5:00pm EST.
Primary Responsibilities:
  • Partner with clinical, operational, and enterprise teams on coding initiatives, including benefit digitization programs, serving as a subject matter expert and providing strategic guidance to support successful implementation.
  • Develop, implement, and promote standardized coding methodologies to ensure consistent, accurate, and compliant interpretation and digitization of benefit structures across the organization.
  • Create, maintain, and manage procedure and service code groupings to support accurate benefit alignment and administration.
  • Maintain coding integrity through governance processes, ongoing quality oversight, and adherence to current industry standards, regulatory requirements, and organizational policies.
  • Manage quarterly and annual industry-standard code updates, benefit plan changes, and mandate-driven coding enhancements to ensure continued compliance and operational accuracy.
  • Provide coding support for benefit administration across diverse markets, including the development of customized coding solutions for complex or nonstandard benefit requests.
  • Serve as the primary resource for coding-related inquiries, delivering clinical expertise, consultation, and guidance to project teams, business partners, and stakeholders.
  • Collaborate across cross-functional workstreams to identify coding impacts, support business and operational initiatives, and drive effective implementation of coding solutions.
  • Ensure coding aligns with regulatory mandates and emerging industry requirements, proactively supporting updates and compliance initiatives.
  • Deliver certified coding expertise and clinical support to meet a broad range of organizational, operational, and strategic business needs.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • High School Diploma/GED or equivalent work experience
  • Must be 18 years of age or older
  • Certified Professional Coder (AAPC or AHIMA)
  • Active unrestricted nursing license
  • 3 + years' experience with coding and reimbursement methodologies (e.g. CPT, HCPCS, ICD-10, CMS,).
  • Intermediate proficiency in Microsoft Office applications, including Word (create, edit, format, and manage professional documents), Excel (analyze data, create reports, utilize formulas, pivot tables, and data visualization tools), and PowerPoint (develop professional presentations and effectively communicate information to a variety of audiences)
  • Ability to work full-time (40 hours/week), Monday - Friday. Employees must work an 8-hour shift during business operating hours of 8:00am-5:00pm EST.

Preferred Qualifications:
  • Experience working with UnitedHealthcare (UHC) benefit plans, including interpretation and application of member benefits, coverage guidelines, and plan design
  • Experience in claims, medical policy, benefits/product administration, and/or medical management

Telecommuting Requirements:
  • Ability to keep all company sensitive documents secure (if applicable)
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:
  • Ability to analyze and translate data to develop recommendations for action plans
  • Excellent written and verbal communication skills
  • Able to work with minimal supervision
  • Flexible with a strong ability to multitask

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • High School Diploma/GED or equivalent work experience
  • Must be 18 years of age or older
  • Certified Professional Coder (AAPC or AHIMA)
  • Active unrestricted nursing license
  • 3+ years experience with coding and reimbursement methodologies (e.g., CPT, HCPCS, ICD-10, CMS)
  • Intermediate proficiency in Microsoft Office (Word, Excel, PowerPoint)
  • Ability to work full-time (40 hours/week), Monday - Friday, 8:00am-5:00pm EST
  • Ability to keep company sensitive documents secure and maintain information privacy
  • Dedicated work area with access to high-speed internet
  • Experience working with UnitedHealthcare benefit plans (preferred)
  • Experience in claims, medical policy, benefits/product administration, and/or medical management (preferred)

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
Metro Manila, Philippines
Cebu, Philippines
Davao, Philippines
Ann Arbor, MI
Atlanta, GA
Baltimore, MD
Bengaluru, India
Chennai, India
Dallas, TX
Detroit, MI
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Hartford, CT
Houston, TX
Hyderabad, India
Jacksonville, FL
Las Vegas, NV
Letterkenny, Ireland
Louisville, KY
Madison, WI
Minneapolis, MN
Nashville, TN
New Delhi, India
Philadelphia, PA
Phoenix, AZ
Pune, India
Raleigh, NC
San Diego, CA
Washington, DC
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