Role Description MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings. These coding practitioners analyze and abstract patients' health records, and assign alpha-numeric codes for each diagnosis and procedure. Announcement will close once 30 applicants is reached. Responsibilities include: - Assigns codes to documented patient care encounters (inpatient and outpatient); encounters are routine and less complex or for only one specialty or subspecialty. - Has basic knowledge of medical terminology, anatomy & physiology, diseases, treatments, diagnostic tests, and medications to ensure proper code selection. - Selects and assigns codes from the current version of one or more coding systems including ICD, CPT, and/or HCPCS. - Adheres to accepted coding practices, guidelines, and conventions to ensure ethical, accurate, and complete coding. - Maintains current knowledge of regulatory and policy requirements affecting coded information. - Reviews health record documentation to abstract all required medical, surgical, ancillary, demographic, social, and administrative data. - Assists facility staff with basic documentation requirements and coding requirements. - Uses knowledge of the organization and structure of the patient health record to capture and justify code assignment. - Utilizes the facility computer system and software applications to code, abstract, record, and transmit data to the national VA database. - Works within a team environment; supports peers in meeting goals and deadlines. - Identifies the principal diagnosis and principal procedure for every inpatient discharge for one specialty or subspecialty. - Codes inpatient professional fee services for identified inpatient admissions. Qualifications - U.S. Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Experience: One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - Education: An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree. - Certification: Must have either Apprentice/Associate Level Certification, Mastery Level Certification, or Clinical Documentation Improvement Certification through AHIMA or AAPC. Requirements - GS-4: None beyond basic requirements. - GS-5: One year of creditable experience equivalent to the next lower grade level; or successful completion of a bachelor's degree with a major in health information management. - GS-6: One year of creditable experience equivalent to the next lower grade level. - GS-7: One year of creditable experience equivalent to the next lower grade level. - GS-8: One year of creditable experience equivalent to the next lower grade level. Benefits - Work Schedule: Monday-Friday, 7:30am-4:00pm Mountain Time. - Telework: Not applicable, this is a remote position. - Relocation/Recruitment Incentives: Not Authorized. - Permanent Change of Station (PCS): Not Authorized.

Role Description As a Senior Ambulatory Medical Coder Edits, you will work remotely to accurately determine CPT and ICD-10 Edits for all types of Professional Coding Services. You will ensure that all coding assignments are accurate according to coding policies and based on the documentation provided in the medical record. Using a thorough knowledge of coding policies and procedures as well as medical terminology and technology, you will be responsible for providing documentation feedback to physicians under the direction of the Coding Operations Manager or Quality Management personnel. This position is full-time (40 hours/week) Monday-Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Identify appropriate assignments of CPT and ICD-10 Edits for Professional Services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility. - Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity accounts. - Adhere to the ethical standards of coding as established by AAPC and/or AHIMA. - Adhere to and maintain required levels of performance in both coding quality and productivity as established by Optum360. - Provide documentation feedback to providers, as needed, and query physicians when appropriate. - Maintain up-to-date coding knowledge by reviewing materials disseminated/recommended by the QM Manager, Coding Operations Managers, and Director of Coding/Quality Management, among others. - Participate in coding department meetings and educational events. - Additional responsibilities as identified by manager. Qualifications - High School Diploma/GED (or higher). - Professional coder certification with credentialing from AHIMA and/or AAPC (CCA, CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC, and CPC-A) to be maintained annually. - 2+ years of Professional/Ambulatory coding experience for all chart types, Same Day Surgery, Observation, Emergency Department, Ancillary services, and Clinics. - 1+ years of experience working with LCD, NCD, Medical Necessity, Modifier Edits, OCE, MUE and NCCI classification and reimbursement structures. - 1+ years of experience working with coding payer denials. - Expert level of proficiency in CPT and ICD-10-CM coding. - Ability to use a PC in a Windows environment, including MS Excel and EMR systems. Preferred Qualifications - Experience with various encoder systems (Encoder, EPIC). Telecommuting Requirements - Required to have a dedicated work area established that is separated from other living areas and provides information privacy. - Ability to keep all company sensitive documents secure (if applicable). - Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (all benefits are subject to eligibility requirements). 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. Company Description 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

PRMO Established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke Primary Care. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke’s reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. *Now offering a $10,000 sign-on bonus that will pay out in 4 equal installments over 24 months - 6-month increments. Occ Summary- The Medical Records Coder II (Inpatient) is a certified Coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM, ICD-10-PCS and/or CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Duties and Responsibilities of this Level Review the complex (problematic coding that needs research and reference checking) medical records and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM, ICD-10-PCS and/or CPT coding conventions. Coordinate/review the work of designated employees. Ensure quality and quantity of work performed through regular audits. Assist with research, development and presentation of continuing education programs on areas of specialization. Review medical record documentation and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM, ICD-10-PCS and/or CPT-4 coding conventions. Sequence the diagnoses and procedures using coding guidelines. Ensure DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Consult with and educate physicians on coding practices and conventions in order to provide detailed coding information. Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM, ICD-10-PCS and/or CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures. Maintain a thorough understanding of medical record practices, standards, regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Health Care/Finance Administration (HCFA), Medical Review of North Carolina (MRNC), etc. Assist with special projects as required. Perform other related duties incidental to the work described herein. Required Qualifications at this Level Education: High school diploma required. Experience RHIA certification- no experience required RHIT certification- no experience required CCS certification- one year of coding experience required CPC or HCS-D certification- two years of coding experience required Degrees, Licensures, Certifications Must hold one of the following active/current certifications: Registered Health Information Administrator (RHIA) Hospital Coding RegisteredHealth Information Technician (RHIT) Hospital Coding Certified Coding Specialist (CCS) Hospital Coding Certified Professional Coder (CPC) Homecare Coding Specialist-Diagnosis (HCS-D) Homecare Coding Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

About ReKlame Health Sixty million adults experience mental health challenges in the United States, yet one-third lack access to proper care. Opioid overdose is the number one cause of death for people under 50 in the United States. We are a clinician-led, tech-enabled provider group that exists to provide culturally competent behavioral health care addiction care, medication management, crisis intervention, and care coordination for people working towards taking back control of their lives, while expanding access to care. Our vision at ReKlame Health is to create a future where individuals who have historically been unable to access the care they deserve can readily obtain high-quality behavioral health and addiction care. At ReKlame Health, it goes beyond mere employment; it's about becoming a part of a formidable movement transcending individuality. Let's unite and forge a world where health equity and effortless access to exceptional mental healthcare can co-exist. About the Role We are seeking a detail-oriented Coding & RCM Specialist to support accurate coding and clean claims submission in a complex Medicaid and managed-care environment. This is a hands-on, production-focused role centered on CPT and ICD-10 coding accuracy and documentation review. You will partner with Revenue Cycle, Clinical Operations, and Finance to ensure services are coded correctly, documentation supports billed services, and common denial risks are caught early. This role is ideal for someone with 3–5 years of coding experience who enjoys detail-oriented work, pattern recognition, and improving claim quality through consistent execution. Key Responsibilities - Coding & Claim Accuracy - Own CPT/ICD-10 coding and strategy across psychiatry and medication management, with a focus on high-acuity and complex patient populations. - Review clinical documentation (eg SOAP notes) and supporting information to ensure clean claim submission. - Improve first-pass claim acceptance by proactively ensuring correct coding, flagging inconsistencies, and documenting gaps for correction. - Audit & Quality Review Support - Perform pre-bill and post-pay audits on a rolling basis. - Review EOBs and denial trends to identify recurring coding issues. - Document audit findings using structured templates and tracking tools. - Flag systemic risks to improve the process and escalate high-risk patterns or unusual payer behavior when necessary. - RCM Collaboration - Work closely with billing team members, senior management, and vendors to resolve claim issues. - Support coding corrections and resubmissions, provide clarification, and maintain internal reference guides for other team members when necessary. - Compliance & Coding Standards - Ensure compliance and alignment with CMS, state Medicaid, and managed-care guidelines. - Monitor changes in payer policies and stay up to date on behavioral health and psychiatry guidelines. - Partner with the credentialing and billing teams on implementing new payer contracts and RCM workflows. You will love this role if: - Certifications: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS). - Technical Skills: Advanced proficiency with ICD-10, CPT, and HCPCS coding systems. Experience working with EHR systems, clinical notes, and medical billing software required. - Experience working with RCM and billing vendors is a strong plus. - Experience: Minimum of 3-5 years of professional experience in medical coding and billing required. - Strong preference for candidates with experience in behavioral health coding and expertise in Medicaid and managed-care systems. - Detail-Oriented: Exceptional accuracy and attention to detail in coding/billing and documentation. - Regulatory Knowledge: Strong understanding of HIPAA and healthcare compliance guidelines, with the ability to adapt to changing regulations. - Experience with denial resolutions, coding audits, and QA review preferred. - Problem-Solving Expertise: Analytical mindset with the ability to address complex challenges, identify solutions, and implement improvements with speed and accuracy. Must be comfortable with EOBs, patterns, and payer behavior. If you’re hungry for a challenge in 2026, love solving problems, and want to be a part of something transformational, we’d love to hear from you! Learn more about us at www.ReKlamehealth.com *We never ask for money or sensitive personal information during the job application process. If you receive an email or message claiming to be from us that requests such information, please do not respond and report it as a scam. ReKlame Health considers several factors to ensure a fair and competitive offer when evaluating compensation packages. These include the scope and responsibilities of the role, the candidate's work experience, education, and training, as well as their essential skills. Internal peer equity is also examined to maintain balance within the organization. Additionally, current market conditions and overall organizational needs are crucial in shaping the final offer. Each aspect is thoughtfully reviewed before extending an offer, ensuring a comprehensive and equitable approach. ReKlame Health is an equal opportunity employer. We celebrate diversity and are committed to creating a supportive and inclusive environment for all employees. If you’re hungry for a challenge in 2025, love solving problems, and want to be a part of something transformational, we’d love to hear from you! Learn more about us at www.ReKlamehealth.com *We never ask for money or sensitive personal information during the job application process. If you receive an email or message claiming to be from us that requests such information, please do not respond and report it as a scam.