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.
Primary Responsibilities:
- Auditing coded medical records using the ICD-10 and CPT
- Know and adhere to HIPAA regulations
- Recognize, interpret and evaluate inconsistencies, discrepancies and inaccuracies in the medical data received and appropriately alert and/or query the responsible party, coder and supervisor
- Meet auditor quality and productivity standards and deadlines/turnaround times set up for the process
- Educate coders through feedback on errors
- Analyze, report and conduct sessions on error trend observed
- Conduct/participate/lead calibration calls between SMEs, auditors and trainers
- Report malpractices noticed during auditing of any coder
- Educate coders on coding updates
- Carefully demarcates between educational feedback and errors
- Reviews rebuttals with integrity
- 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 regards 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
Required Qualifications:
- Education Background:
- Graduate or Postgraduate in: Life Sciences, Allied Medicine (BHMS, BAMS, BPT, Dental Grads, Pharmacist, Nursing)
- Certification:
- Should be a certified coder - AAPC / AHIMA - CCS/CPC/CPC-H/CCS-P
- 5+ years of coding experience in relevant specialty IPDRG
- Thorough knowledge of medical terminology, human anatomy/ physiology, pathophysiology
- Understanding of interpreting the medications and dosages
- Proven good in English communication
- Demonstrated ability to provide proper and detailed feedback on errors and conduct/provide training based on error trends
- Demonstrated ability to participate/conduct/lead calibrations between SMEs, auditors and trainer group
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.
Skills Required
- Graduate or Postgraduate in Life Sciences or Allied Medicine (BHMS, BAMS, BPT, Dental, Pharmacist, Nursing)
- Certified coder (AAPC/AHIMA) - CCS, CPC, CPC-H, or CCS-P
- 5+ years of coding experience in relevant specialty IPDRG
- Proficiency auditing coded medical records using ICD-10 and CPT
- Thorough knowledge of medical terminology, human anatomy, physiology, and pathophysiology
- Ability to interpret medications and dosages
- Strong English communication skills
- Demonstrated ability to provide detailed feedback, conduct training, and analyze error trends
- Demonstrated ability to participate in, conduct, and lead calibration sessions between SMEs, auditors, and trainers
- Knowledge of and adherence to HIPAA regulations
Optum Compensation & Benefits Highlights
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Healthcare Strength — Official materials highlight copay and HSA medical plan choices with in‑network preventive care at 100%, prescription coverage, and low/no‑cost virtual visits, plus company HSA contributions. Dental preventive services are 100% in network, and mental health resources include an EAP and premium Calm access.
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Parental & Family Support — Programs include six weeks paid parental leave, up to two weeks paid caregiver leave, and Bright Horizons back‑up care with enhanced family supports. Adoption assistance up to $10,000 for full‑time employees reinforces family‑oriented benefits.
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Equity Value & Accessibility — Financial benefits include an Employee Stock Purchase Plan at a 10% discount, expanding access to equity ownership.
Optum Insights
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.
