Title: Coding Denials & Auditing Supervisor Requisition number: 2363406 Job category: Medical & Clinical Operations Primary location: Middletown, NY Overtime status: Exempt Travel: No Job Description: Optum NY/NJ, is seeking a Coding Denials & Auditing Supervisor Coding to join our team in Remote, Nationwide. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Coding Denials & Auditing Supervisor is responsible for the oversight of coding denial resolution, coding quality auditing, and compliance monitoring across professional fee services. This role ensures accurate, complete, and compliant coding practices while reducing denial volume, improving first-pass yield, and supporting revenue integrity initiatives. The Supervisor leads a team of coding denial specialists and/or auditors, drives root cause analysis, and partners with coding, charge capture, and provider teams to identify trends and implement sustainable process improvements. Schedule: Monday to Friday, 8:00 am to 5:00 pm EST Location: Remote Nationwide You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Denials Management Oversight - Supervise daily operations of coding denial work queues, ensuring timely and accurate resolution of payer denials - Establish productivity and quality expectations for denial staff and monitor performance against targets - Review complex denials and provide guidance on appropriate coding corrections, appeals, or education opportunities - Identify denial trends (e.g., bundling, modifier usage, medical necessity) and escalate systemic issues - Auditing & Quality Assurance - Oversee routine and targeted coding audits (prospective and retrospective) to ensure compliance with applicable coding standards - Ensure audits are conducted using CPT, ICD-10-CM, HCPCS, CMS, and payer-specific guidelines - Validate audit accuracy, scoring methodology, and consistency across auditors - Maintain audit schedules aligned with compliance requirements and organizational priorities - Performs other duties as assigned What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: - Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays - Medical Plan options along with participation in a Health Spending Account or a Health Saving account - Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage - 401(k) Savings Plan, Employee Stock Purchase Plan - Education Reimbursement - Employee Discounts - Employee Assistance Program - Employee Referral Bonus Program - Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction 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 - CCS, CPC, or equivalent certification required - 5+ years of professional coding experience - 5+ years of experience in denials management, auditing, or coding quality review - Access to a designated quiet workspace in your home (separated from non-workspace areas) and is able to secure Protected Health Information (PHI) - Must live in a location where there is a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service - Ability to work Monday through Friday 8:00 am to 5:00 pm EST Preferred Qualifications: - 5+ years of professional coding experience multi-specialty preferred - 1+ years of prior supervisory or leadership experience - CEMA certifications Soft Skills: - Ability to work independently and maintain good judgment and accountability - Demonstrated ability to work well with health care providers - Strong organizational and time management skills - Ability to multi-task and prioritize tasks to meet all deadlines - Ability to work well under pressure in a fast-paced environment - Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others - Ability to collaborate with your work team - All Telecommuters 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. 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. #RPO #GREEN

• Handle complex account follow-up, denials, and claims resolution • Review, resubmit, and follow up on complex insurance claims • Perform detailed account research and update account information accurately • Resolve denials and ensure adherence to payer contract requirements • Maintain work queues and ensure timely resolution of accounts • Provide support to teammates and cross-train in additional revenue cycle functions • Demonstrate strong documentation, analytics, professionalism, and customer service

Role Description Responsible for reviewing and abstracting inpatient medical records, as well as identifying and assigning accurate medical codes for diagnosis, procedures, and services in an inpatient setting. The Coding Specialist ensures that all data elements required for federal or state reporting and billing are collected and included in the patient’s demographic record. Typically reports to the Coding Manager. Qualifications - High School Diploma or GED required; Associates degree in Health Information Management or any Healthcare Related Field preferred. - Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), or Certified Inpatient Coder (CIC) Coding Certification(s) from American Health Information Management Association (AHIMA) or American Association of Professional Coders (AAPC) required. - Five (5) years of inpatient hospital coding experience required. - Experience coding in a level 1 trauma facility/academic teaching facility strongly preferred. - Effective oral and written communication skills. - Strong knowledge of ICD-10-CM and PCS coding. - Analytical skills necessary to interpret data contained in the health records and to assign appropriate codes. - Strong knowledge of human anatomy, physiology, medical terminology, and surgical terminology. - Critical thinking, good judgment, and decision-making skills. - Knowledge of coding compliance policies, official coding guidelines, regulatory requirements, and internal policies and procedures affecting the coding process. - Proficient in navigating a Windows-based application environment. Requirements - Reviews medical record documentation to identify pertinent diagnosis/procedures that require code assignment for inpatient records and accurately code the diagnoses and procedures using ICD-10 coding conventions for the purpose of reimbursement, research, and compliance with federal regulations. - Reviews the medical record to assure specificity of diagnoses, procedures, and appropriate reimbursement for hospital and professional charges. - Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. - Keeps abreast of coding guidelines and reimbursement reporting guidelines and brings identified concerns to manager for resolution. - Effectively assigns ICD-10 codes and DRGs to inpatient records. - Responsible for maintaining 92% to 95% in ICD-10 and DRG assignment and consistently meet established productivity standards while keeping abstracting errors to a minimum. - Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines. - Ensures safe care to patients, staff, and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and quality of service. - Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff. - Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized, and efficient experiences to patients and colleagues. - Other duties as assigned.

Role Description This full-time remote position is responsible for accurately correcting coding-related denials for billing in Epic, including writing appeal letters when appropriate. The right candidate will bring strong technical coding knowledge, a solutions-oriented mindset, and the ability to work independently while maintaining high accuracy standards. - Accurately correct coding-related denials for billing in Epic, including writing appeal letters when appropriate. No phone calls to payers required. - Ensure timely correction and completion of patient accounts to meet established department standards and goals. - Maintain 95% accuracy or greater in accordance with department standards. - Apply advanced knowledge of medical coding rules and regulations, including compliance, payer policy, CMS regulation, and CCI. - Attend meetings as required. - Work independently in a remote environment with excellent written and verbal communication skills. - Contribute positively to team culture by being willing to assist wherever needed. Qualifications - High School Diploma or equivalent. - Completion of formal coursework in medical terminology, disease processes, anatomy and physiology, and medical coding and regulatory compliance. - Required: Coding certification through AHIMA (RHIA, RHIT, CCS, CCS-P, CCA) or AAPC (CPC, COC, CEMC). Requirements - Strong technical coding knowledge. - Solutions-oriented mindset. - Ability to work independently while maintaining high accuracy standards. Benefits - Supportive Environment: Join a team that values collaboration and provides an atmosphere where your contributions are recognized. - Growth Opportunities: Access to all areas of revenue cycle management with opportunities for professional development. - Competitive Compensation: Attractive salary and benefits package. - Flexibility: Remote work with flexible scheduling. - Career Stability: Be part of a stable, growing organization with a 45-year track record and a strong future.