• Analyze and interpret complex records to identify and accurately bill for Trauma 1 facility Inpatient services. • Assign and sequence correct diagnostic and procedure codes in compliance with third party payor requirements. • Obtain clarification when presented with conflicting, ambiguous, or non-specific documentation.

Role Description As our Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. - Accurately translate patients’ medical records into standardized codes for diagnoses and treatments. - Ensure compliance with legal, regulatory, and organizational standards. - Combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. - Maintain clear communication with providers and staff. - Efficiently manage records to ensure claims are processed correctly and on time. This position is work from home within California. As a remote employee, we will provide you with the equipment needed to work from home, including a laptop, docking station, dual monitors, and accessories. - Applies coding principles consistent with government regulatory standards, payer specific guidelines, and Dignity Health Medical Foundation policy. - Codes Primary Care, Radiology, and Hospitalist professional charges for assigned providers. - Reviews all ICD, E&M, CPT, and HCPCS codes to ensure documentation supports all services rendered. - Queries providers, as needed, when encounters lack clear documentation or when missing documentation is discovered in the medical record. - Provides education to physicians and providers on coding and documentation, as needed. - Assists clinic and other department staff with coding related questions pertaining to assigned providers. Qualifications - One (1) year or less of professional fee coding experience. - High school diploma or equivalent. - CPC, CPC-A or CCS-P Certification. Requirements - GECB/IDX and Cerner experience preferred.

Role Description Reviews patient records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work. Qualifications - High School Education/GED or equivalent: Preferred - Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred - Two years' coding experience: Preferred - Two years' healthcare experience: Preferred - Certified Coding Specialist (CCS) or Outpatient Certified Professional Coder (CPC) or Certified Interventional Radiology Cardiovascular Coder (CIRC) or Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Specialist-Physician Based (CCS-P) or Certified Coding Associate (CCA) or Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT): Required - CCS OR CPC OR CIRCC-AAPC OR CC-AAPC OR CCS-Phy OR CCA OR CCC OR RHIA OR RHIT OR CPC-A: Required Requirements - Abstracts and assigns diagnosis codes and procedure codes from the patient record to provide information required for billing and reimbursement. - Audits medical records to ensure proper coding is completed and to ensure compliance with federal and state regulatory agencies. - Follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies. - Collaborates to provide coding feedback and education to departmental leadership regarding completeness and accurateness of documentation and physician coding practices. - Analyzes content of reports and software edits to facilitate revisions with appropriate departments (Ancillary and Emergency Department Coding only). - Performs other job-related duties as assigned. Organizational Requirements Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit this link for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein. Company Description Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

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