CCL Certified Professional Coder‑Auditor – National Remote (U.S.)
Company: Optum (UnitedHealth Group)
Category: Medical & Clinical Operations – Coding & Audit
Work Mode: Remote (Telecommute anywhere in the U.S.)
Compensation: $23.41 – $41.83 per hour (based on full‑time employment & eligibility)
Job Summary (Healthcare-focused)
Optum is hiring a CCL Certified Professional Coder‑Auditor to deliver end‑to‑end ICD‑10‑CM, CPT, HCPCS coding and auditing services, resolve denials, mentor providers, and ensure compliance with NCCI edits, federal/state regulations, payer policies, and revenue cycle integrity. This fully remote role is ideal for coders who thrive on quality audits, documentation improvement, query management, and productivity/accuracy benchmarks in a high-volume U.S. healthcare environment.
Key Responsibilities
Translate clinical documentation (diagnoses, procedures, E/M, ancillary services) into accurate ICD‑10‑CM, CPT & HCPCS codes.
Apply NCCI edits, LCD/NCD guidance, payer rules, and federal/state regulations.
Query providers to clarify incomplete/unclear documentation and finalize code determinations.
Resolve coding edits/denials and meet TAT, productivity, and quality KPIs.
Perform and respond to coding quality audits; document discrepancies and corrective actions.
Educate and mentor on coding quality, documentation standards, and compliance.
Utilize multiple EMR/coding software applications and Microsoft Office for analysis and reporting.
Maintain active certifications and adhere to AAPC/AHIMA ethical standards.
Required Skills & Qualifications
Active coding credential: CPC, CPC‑H, CCS or CCS‑P (CPC‑A & GYN not accepted) OR RN with 5+ years of coding experience.
2+ years of professional medical coding experience.
Intermediate proficiency in Microsoft Word, Excel & Outlook.
Solid working knowledge of ICD‑10‑CM, CPT, HCPCS, NCCI and documentation rules.
Preferred
Hospital and/or physician practice coding experience.
Specialty coding exposure (e.g., musculoskeletal, neurology, neurosurgery, surgery, emergency medicine).
Proven experience performing coding audits and quality reviews.
(Note: While classic pharma PV tools like MedDRA/GVP/ICH‑GCP are not core to this role, candidates must demonstrate deep expertise with ICD‑10‑CM/CPT/HCPCS, NCCI, HCC, federal & payer policies, and audit/compliance standards.)
Perks & Benefits
Comprehensive medical, dental, vision plans
401(k) contribution & Employee Stock Purchase Plan (ESPP)
Incentive & recognition programs
Robust PTO & paid holidays
Continuous CE/CME, certification maintenance & career growth across Optum/UHG
Company Description (SEO-rich)
Optum, part of UnitedHealth Group, is a technology-enabled healthcare leader that connects millions to better care, pharmacy benefits, actionable data, and value-based solutions. With a national footprint and clinician-led teams, Optum drives coding quality, compliance, and health equity while optimizing the health system for patients, providers, and payers.
Work Mode
Remote / Telecommute (Anywhere in the U.S.)
Apply Now
Ready to elevate coding quality and compliance at scale? Apply now and grow your coding & auditing career with Optum’s national remote team.
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Duluth | Eden Prairie | Fridley | Hibbing | Maple Grove | Minneapolis and St. Paul, Minnesota. | Minnetonka | St.Paul |Missouri :
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China | Quarry Bay |Hubei :
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Zaventem |Bosnia and Herzegovina :
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