Description

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.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Leadership & Staff Management

• Supervise day-to-day operations of the coding team (inpatient, outpatient, professional, or specialty coders)
• Provide coaching, mentoring, and performance evaluations for coding staff
• Monitor productivity and quality metrics, ensuring teams meet organizational benchmarks
• Develop and maintain staff schedules, manage PTO, and ensure adequate coverage
• Lead regular team meetings and training sessions to communicate updates and reinforce expectations

Coding Quality & Compliance

• Ensure coding accuracy and adherence to ICD-10-CM, CPT, HCPCS, and payer-specific guidelines
• Conduct routine and targeted coding audits; provide feedback and corrective action plans
• Stay current with industry regulations (CMS, OIG, NCCI edits, payer bulletins)
• Ensure compliance with organizational policies, regulatory requirements, and ethical standards

Workflow & Process Management

• Oversee daily work queue (WQ) review, assignment of cases, and timely resolution of holds/deficiencies
• Identify barriers and streamline workflows to reduce coding delays and improve revenue cycle performance
• Partner with HIM, billing, charge capture, clinical departments, and revenue integrity to resolve coding or documentation issues
• Escalate system or operational concerns and help develop corrective action plans

Education & Training

• Provide ongoing education to coders regarding guideline changes, documentation requirements, and payer rules
• Collaborate with physicians and clinical departments to improve documentation quality and clarity
• Develop training materials for new hires and support onboarding processes

Systems, Tools & Reporting

• Monitor coding dashboards, WQs, and productivity reports
• Participate in EHR or encoder updates, charge capture logic reviews, and testing (e.g., logic changes, edits, workflow redesigns)
• Maintain accurate documentation of policies, procedures, and team workflows

Revenue Cycle Support

• Partner with billing, editing, and denials teams to investigate and resolve claim holds, rejections, and denials
• Analyze trends in denials or payer behavior and implement corrective education or workflow enhancements
• Support charge capture accuracy and collaborate on organizational initiatives impacting reimbursement

Collaboration & Communication

• Serve as the operational contact for coding-related questions from internal departments
• Communicate coding changes, payer updates, and organizational initiatives clearly and timely
• Participate in leadership meetings and contribute to strategic planning for the coding/HIM department

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
• Professional CPC coder certification with credentialing from AHIMA and/or AAPC to be maintained annually
• 3+ years of medical coding experience in pro-fee coding
• 1+ years in supervisory or lead experience (SME experience will be considered for qualification) and the ability to lead, coach, mentor and evaluate coding staff

Preferred Qualifications:

• Associate's or Bachelor's degree
• Ability to maintain confidentiality and demonstrate professional ethics
• Comfortable driving process improvement initiatives and operational changes

Soft Skills:

• Strong interpersonal skills and ability to collaborate with coding, billing, clinical and revenue cycle teams
• Excellent written and verbal communication skills for interacting with clinicians and leadership
• High attention to detail and commitment to accuracy

*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 $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO, #GREEN