Medical Coder

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.  

The Home Health Coder is responsible for reviewing clinical documentation and applying accurate ICD 10 CM diagnosis codes and OASIS-based coding guidance to support compliant and optimized reimbursement for home health services. This role ensures coding accuracy, regulatory compliance, and timely submission of claims while collaborating with clinicians and QA teams to resolve documentation gaps.

Primary Responsibility

• 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)
  • Any medical coding certification (CPC,CCS etc) is required; BCHH C is preferred
• Certification:
  • Should be a certified coder - AAPC / AHIMA - CCS/CPC/CPC-H/CCS-P / BCHH
• Experience:
  • Experience in Acute Surgery or ED coding
  • Proficient in Human Anatomy, Medical Terminology and Diagnosis coding
  • Good in English communication
  • High Analytical skills
  • Willingness and eager to learn and grow
• Skills:
  • Expertise in coding diabetes, wounds, fractures, CVA late effects, COPD, CHF, etc.
  • Understanding of PDGM (Patient-Driven Groupings Model):
    • Primary diagnosis selection
    • Comorbidity adjustments
  • Skill in identifying missing, conflicting, or insufficient documentation
  • Ability to perform provider queries when needed
  • Analytical thinking and problem solving
  • Solid command over ICD 10 CM guidelines (Chapters 1-21)
  • Ability to apply etiology/manifestation coding rules

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.