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.
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.
