Title: Coding Denials & Auditing Supervisor Location: Remote United States Overtime status: ExemptTravel: 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. 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

Role Description The Inpatient Coding Specialist III will support the importance of accurate, complete and consistent coding practices for the production of quality healthcare data. The person in this role should be proficient in coding the most complex types of coding cases (Inpatient) applying the correct ICD-9/ICD-10-CM diagnosis codes, the newly developed and mandated ICD-10-PCS codes to inpatient procedure cases and strive for optimal reimbursement. The Coding Specialist III will have the ability to float to different coding areas as needed. - Location: 100% Remote - Schedule: Part time (Monday – Friday) - 20 hours per week - Typical Hours: Between 5:00 am – 5:00 pm CST Qualifications - Inpatient Coding (facility) in an Acute Care Hospital preferred - 2+ years medical record coding experience and knowledge of DRG assignment and reimbursement regulations as acquired in an acute care environment preferred - Requires experience coding through an encoder and should be proficient with Windows based applications required - Coding for pediatric cases preferred Requirements - One of the following certifications is preferred: - CCS-Certified Coding Specialist - American Health Information Management Association - RHIT-Registered Health Information Technician - American Health Information Management Association - RHIA-Registered Health Information Administrator - American Health Information Management Association - Requires knowledge of ICD-9-CM/ICD-10-CM, ICD-10-PCS and CPT classification systems as well as the Official Guidelines for Coding and Reporting. - Requires excellent verbal and written skills to facilitate communications with medical staff, peers, management and other hospital personnel. - Requires ability to adapt and participate in frequent changes of policies and procedures in response to internal and external requirements for health care data. - Requires ability to maintain accuracy, work independently and resolve problems effectively. Education - High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) required Company Description Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

• Ensure accurate and appropriate gathering of information into coding classification systems • Responsible for coding of moderately complex patient classes i.e. ED, observations, same day care, etc. • Reviews and accurately interprets medical record documentation • Assigns hospital codes to a variety of patient classes (i.e. ED, OBS, SDC, etc.) • Assures that quality and timely coding, charging, and abstraction of accounts are completed daily • Maintains and enhances current levels of coding knowledge

Role Description The Pro Fee Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement. The Coder II may validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals. The Coder II performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder II may interact with client staff and providers. Duties and Responsibilities: - Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee; Technical Fee or Evaluation and Management, any associated chart capturing with any patient type. - Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes accurately reflect the diagnoses/procedures documented in the clinical record. - Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected. - Complete assigned work functions utilizing appropriate resources. May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries. - Maintain strict patient and provider confidentiality in compliance with all HIPAA Guidelines. - Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required. - Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing. - Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials. Qualifications - Candidates must successfully pass pre-employment skills assessment. - An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS, CCA, or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential. - Two years of recent and relevant hands-on coding experience. - Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets. - Ability to consistently code at 95% threshold for quality while maintaining client-specific and/or Savista production and/or quality standards. - Proficient computer knowledge including MS Office including the ability to enter data, sort and filter excel files (Outlook, Word, Excel). - Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers. Requirements - Recent and relevant experience in an active production coding environment strongly preferred. - Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience. - Experience using RCx, Cerner, NextGen (a plus). - Academic and Split-Share experience. Benefits - Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $22.08 - $34.69 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills. Company Description Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).