Medical Coder - ED Facility

Company Overview

Optum is a global healthcare company that operates in the field where care, technology, pharmacy benefits, data and health operations come together. It is a subsidiary of UnitedHealth Group and helps to optimise and streamline the efficiency of healthcare operations through its operations.

This is because, with today's modern healthcare system, the behind-the-scenes operations of healthcare are complex. For any patient interaction within the healthcare network, there will be several teams responsible for managing documentation, data, compliance, coding, insurance operations, and other aspects of healthcare operations. And thus, Optum is a significant player in building this operational support structure in healthcare around the world.

The working environment in Optum is characterised by structured processes, teamwork, compliance, and learning. There is scope for gaining experience in international healthcare processes, technology-driven operations, and large-scale healthcare delivery systems.

This could be an excellent start-up point into corporate healthcare organisations. This role allows healthcare/life science graduates to engage in clinical documentation and coding operations while participating in a global health operation ecosystem.

The scope at Optum is suitable for candidates looking for a career platform in medical coding, clinical documentation, healthcare compliance, revenue cycle management, health operations, and global healthcare services.

Job Summary

In your position, you will assist in coding the medical records of the emergency department of a hospital or a clinic in terms of documentation of their diagnoses, procedures, and modifiers used. This is a practical opportunity to get involved in a medical coding process as part of documentation. You will have to learn how to use ICD-10-CM, CPT, and HCPCS Level II codes as well as comprehend relationships between modifiers, procedures, supplies, equipment, and clinical documentation in regards to medical coding.

If you prefer to avoid dealing with patients, then such role might be a good way into healthcare for you as it will not require you to treat patients in any way. Instead, you will be involved in handling their clinical records and helping to convert documentation of hospitals into structured codes that will ensure efficient processing of information in regard to healthcare issues.

Since you will be under direct supervision, the position can suit you as a candidate as you will be learning to code emergency department processes at a hospital. Nevertheless, this role will expose you to ICD-10-CM guidelines, CPT rules, CMS, Coding Clinic of AHA, NCCI edits, HCPCS coding, and client coding guidelines.

Key Responsibilities

• You will use the medical record information in Urgent Care Centres and the Emergency Department settings. Study the records thoroughly, find relevant medical information, and assign appropriate medical codes accordingly.

• You will be required to code 12 medical records within an hour while maintaining accuracy in your coding process and meeting the desired standards.

• Also, you will be expected to keep yourself updated regarding the most recent guidelines issued by the AMA, AHA, and CMS for coding procedures. The guidelines assist medical coders to understand the proper coding process.

• Medical records will be reviewed by you for assigning or updating CPT codes for procedures like minor surgeries, vaccines, and laboratory services based on the documentation in the records.

• Moreover, screening services and PQRS codes will also be identified and coded from the patient records.

• You will need to check NCCI edits, LCD rules, and NCD rules. These rules help confirm whether the codes are correct and whether the medical service is covered properly.

• You will organise your work properly and complete coding within the required time. You will also help resolve coding edits so that the work follows regulatory and client guidelines.

• With the management of patients' files, you are expected to ensure that patient information is handled with confidentiality and security.

• You are also required to have knowledge about protecting company systems and health care information from any form of breach or threat. This requires you to follow all security policies and ensure proper conduct towards company systems.

• The other issue that you should be aware of is the company's employment agreement and other related business issues.

Qualifications and Skills

Must-Have Skills

• Graduates of Life Science or Allied Medicine programs are eligible to apply for this position.

• A certified AAPC or AHIMA member would suffice here. It is essential because medical coding requires a person who knows everything about it and the necessary certification.

• At least two years of experience with multispecialty Evaluation and Management coding is required.

• Previous coding experience in the field of Emergency Department coding is required. Previous Critical Care coding experience is required here.

Bonus Skills

• Knowledge regarding medical terminology, human anatomy, and physiology is required in order to comprehend medical records and assign accurate codes.

• The candidate should have experience determining E/M levels depending upon medical decision-making.

• The candidate should also have experience adding appropriate modifiers to CPT codes following the guidelines set forth by NCCI and CPT.

• Knowledge of ICD-10-CM, CPT, and HCPCS guidelines is required.

Soft Skills & Personality Traits

• It is important to be detail-oriented as mistakes in coding can have an effect on billing and compliance.

• The ability to work with medical records, coding guidelines, and structured documentation should come naturally.

• The ability to do the job with precision and accuracy is required in order to manage coding tasks within deadlines.

Salary and Benefits

Optum may offer between ₹3.0 LPA and ₹6.0 LPA to an Emergency Department Facility Medical Coder, according to your certifications and experience. The total compensation will be determined by the kind of experience and understanding you have in medical coding, especially ED facility coding.

Other benefits that you could be getting include:

• Health insurance

• Shift allowance where necessary

• Learning and development opportunity

Career Growth Opportunities

The more successful you become in maintaining accuracy and efficiency in coding and coding practices, the higher the chances are of you developing your career in this area.

Some of these roles include senior medical coder, ED medical coder, quality analyst, coding auditor, clinical documentation specialist, revenue cycle management, compliance support, and many more.

The position is very helpful because it ensures you get exposure to ICD-10-CM, CPT, HCPCS, E/M coding, NCCI edits, CMS guidelines, and ED documentation among other important skills. This gives one the ability to grow within the field of medical coding and global healthcare operations.

Team Structure

You will work under team leader or sometimes need to work independently.

As a member of the coding team, which is big, you will work towards ensuring quality, efficiency, compliance, and the timely completion of medical records.

Why This Role Stands Out

This role stands out because it gives you exposure to emergency department coding, critical care documentation, and global healthcare operations.

How to Apply

Your CV should have relevant keywords like ED coding, urgent care coding, critical care coding, ICD-10-CM, CPT, HCPCS, E/M Coding, modifiers, NCCI edits, AAPC/AHIMA certified, and medical terminology. An organized and specific profile would suit this position well.

Then click on the apply button.

Best of luck!