Role Description - Learn new systems of clients and effectively transfer knowledge to subordinates. - Lead designated team, ensuring accurate and timely submission of deliverables. - Coach subordinates and develop their skills. - Assist Supervisor/Assistant Manager/Manager in directing the team towards the company's goals. - Ensures compliance with company guidelines and procedures. - Addressing any conflicts within the team that may arise. - Create accurate medical insurance claims and ensure timely submission. - Rectify claim denials with resubmission or appeals. - Formulate and execute strategies to mitigate claim denials. - Learn and implement specialty, state, carrier specific billing requirements. Qualifications - Graduate of any allied medical course (Nursing, PT, MedTech, etc.) preferred but not required. - At least 2–3 years of experience in medical billing, preferably with US healthcare accounts. - With leadership or supervisory experience in a medical billing team is preferred. - Strong knowledge of medical insurance claims processing, claim submissions, denials, and appeals. - Experience in analyzing and resolving claim denials and implementing strategies to reduce them. - Strong coaching, mentoring, and team management skills. - Ability to monitor team performance and ensure timely and accurate submission of deliverables. - Strong organizational, problem-solving, and conflict resolution skills. - Excellent communication and coordination skills. - Able to work from home with reliable internet and a backup connection. Benefits - Work from Home - Equipment/company computer is provided

Title: Medical Coder - Observation Location: Eden Prairie United States Job 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. This position is full-time (40 hours/week) Monday-Friday, normal business hours. It may be necessary, given the business need, to work occasional overtime. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Expert knowledge in all facility outpatient coding types: Observation - Identify appropriate assignment of ICD-10 Codes, CPT and modifiers for facility services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility - 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 Optum - Understand the Medicare Ambulatory Payment Classification (APC) codes - Query physicians and forms when appropriate - Knowledge of ICD-10, CPT and HCPCS coding systems, strong medical terminology - Knowledge of NCCI edit policies, Medicare LCD and NCD policies - 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 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 - Professional coder certification with credentialing from AHIMA and/or AAPC (CCA, CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC) to be maintained annually - 2+ years of experience with ICD-10, CPT, and modifiers - 2+ years of experience in observation coding - Intermediate level of experience working with a PC in a Windows environment, including Microsoft Excel (create and edit spreadsheets) and various EMR systems with ease - Intermediate level of attention to detail, accuracy and communication 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 where there is a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service - 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 hourly pay for this role will range from $20 to $36 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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

Role Description The Risk Adjustment Coder with AHIMA or AAPC certification performs medical record diagnosis code abstraction based upon clinical documentation, ICD-10-CM Official Guidelines for Coding and Reporting, AHA Coding Clinic Guidance, CMS program guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Risk Adjustment Coder will apply guidance provided for the medical record code abstraction primarily for Medicaid lines of business (Complete Code Capture), but may also include Medicare Advantage Risk Adjustment or Commercial Risk Adjustment. - Certified through AHIMA or AAPC required (CRC, CPC, CCS, CCS-P Certification Required). Qualifications - Minimum of 3 years certified with a core coding credential from AHIMA or AAPC. - Must be one of the following: CRC, CPC, CCS, CCS-P. - Experience and proficiency working with Medicaid plans (1+ years). - Strong organizational skills. - Technical savvy with high level of competence in basic computers, Microsoft Outlook, Word, and Excel. - Strong written and verbal communication skills. - Ability to work independently in a remote environment. - Minimum of 1 recent year of production coding experience in Retrospective Risk Adjustment coding (must be within last 6 months). - Required code set knowledge and coding experience in Medicaid (primary), Medicare, and Commercial benefit plans. - Minimum of 1 year coding experience with Complete Code Capture. Requirements - Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. - Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education. - Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations. - Ability to pass coding quiz with 80% accuracy. - Consistently maintain a minimum 95% accuracy on coding quality audits. - Meet minimum productivity requirements as outlined by the project terms. - Ability to adhere to client guidelines when superseding other guidelines. - Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes. - Handle other related duties as required or assigned. Benefits - Comprehensive medical, dental, vision, and prescription coverage. - Wellness program supporting overall well-being. - Company-paid basic life and AD&D insurance. - 401(k) plan with company match. - Tuition reimbursement opportunities. - Paid time off for vacation and illness. - Six paid company holidays. - Floating holiday. - Company-paid training and computer equipment. - Performance-based bonus program. - Paid time off for volunteer activities. - Employee referral bonus program. - Career development and training opportunities, including leadership growth.

Title: Benefits Coordinator Location: Oregon, Washington, California, or Colorado. Remote Job Description: Job#: 3027655 Job Description: 6+ month contract, may extend depending on budgets. Most of team is in Oregon so ideally candidates are in California, Oregon, or Washington (PST), but Colorado would be fine as well. Skillset: - Health Insurance background - System knowledge in SharePoint, Sales Connect and Power BI - data oriented, review the insurance and benefit data and know how to audit it before inputting it into the benefit groups - Production oriented - Self motivated - Strong multi tasker - must be able to work in various systems all day long - Healthcare insurance / benefit Auditing experience has been a plus - Experience in: Healthplan Benefits and Large Group Enrollment - Analytical skills - a must, in order to perform accurately and timely on cases, to ensure a first time full resolution is achieved. - Must be able to proactively work in a collaborative Team Environment, demonstrating development of positive relationships with peers. - Great communication skills to timely provide feedback on issues that might affect multiple members. - Flexibility to adapt to and to follow ongoing process changes. (This team is transitioning to several new projects the next couple of years and need to make sure whoever they bring on is okay dealing with constant changes) Published Job Description Apex Systems is seeking multiple Membership and Benefits Project Coordinators to join our esteemed healthcare client. This opportunity is on a Remote basis sitting in Oregon, Washington, California, or Colorado. Compensation: $25-30/hr (overtime of "time and a half" when/if applicable) Schedule: M-F normal business hours PST Benefits: Access to health, dental, vision, 401k, and a weekly pay structure Position Requirements: - High school graduate or GED equivalent required. Associates degree preferred. - Strong organizational, communication, analytical, and problem-solving skills. - Ability to work well in a team environment. - Healthcare payer experience strongly preferred. Responsibilities: - Perform ongoing audits of benefits data to ensure accuracy of data within the payroll systems and benefits vendors. Main Skillset: - Health Insurance Benefits background preferred - System knowledge in SharePoint, Sales Connect and Power BI - Membership benefit data oriented, review the data, audit it before inputting it into the benefit groups - Production oriented - Self motivated - Knowledge of health plan information system technologies - Expertise of Microsoft Office Additional Skills: - Analytical skills - a must, in order to perform accurately and timely on cases, to ensure a first-time full resolution is achieved. - Collaborative team environment. - Strong communication skills to timely provide feedback. - Flexibility to adapt to and to follow ongoing process changes. - Ability to communicate effectively and courteously with customers. - Ability to apply judgment and make autonomous decisions to quickly resolve issues - Demonstrated expertise in dealing with difficult situations. - Experience in enrollment, billing, claims processing, sales, account management or health plan administration in healthcare or health insurance industry. - Knowledge of health plan information system technologies. - Ability to analyze processes, identify and implement process improvements. - Proficiency in computer and analytic skills. Strong knowledge and experience in using multiple client databases & systems Technologies: - SharePoint experience preferred - Sales Connect - Excel required - Word required - MS Teams preferred - Salesforce would be great but not required - Power BI would be great but not required - Tech savvy in general, be able to learn new software quickly, catch on quickly Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico. Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our 'Welcome Packet' as well, which an Everforth Apex team member can provide. Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. Pay Range: $25 - $30 per hour