[Remote] Prepay Coding Consultant
Note: The job is a remote job and is open to candidates in USA. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Prepay Coding Consultant will utilize resources to identify appropriate medical codes, apply understanding of medical coding, and manage multiple work demands while ensuring coding quality. This role also involves educating and mentoring others in coding practices and maintaining professional certifications.
- Responsibilities
- Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules and guidelines
- Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes
- Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes
- Utilize medical coding software programs or reference materials to identify appropriate codes
- Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations
- Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters)
- Provide information or respond to questions from medical coding quality audits
- Educate and mentor others to improve medical coding quality
- Demonstrate basic knowledge of the impact of coding decisions on revenue cycle
- Attain and/or maintain relevant professional certifications and continuing education seminars as required
- All other duties as assigned
- Skills
- High School Diploma/GED
- Certified Coder with credentials from AAPC with a CPC or AHIMA with CCS, RHIT, RHIA
- 3+ years of CPT & ICD coding experience (surgical, hospital, clinic settings)
- Intermediate level of proficiency with PC based software
- Ability to work our normal business hours of 8:00am - 5:00pm, Monday - Friday. It may be necessary, given the business need, to work occasionally overtime or weekends
- Must be 18 years of age or older
- AHFI or CFE certification
- Licensed Registered Nurse (RN)
- Licensed Practical Nurse (LPN)
- Experience in a production environment
- Experience with one or more of the following: Claim processing, Provider demographic information, Insurance billing practices
- Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
- Company Overview
- Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group. It was founded in 2011, and is headquartered in Eden Prairie, Minnesota, USA, with a workforce of 10001+ employees. Its website is https://www.optum.com/.
- Company H1B Sponsorship
- Optum has a track record of offering H1B sponsorships, with 73 in 2026, 648 in 2025, 559 in 2024, 620 in 2023, 851 in 2022, 593 in 2021, 438 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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