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Surgical Profee Medical Coder

3+ years
$20.00 – $35.72 per hour
10 July 25, 2025
Job Description
Job Type: Remote Education: B.Sc./M.Sc/B.Pharm/M.Pharm/Life Science Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

 

Surgical Profee Medical Coder – National Remote (Albany, NY primary location)

Company: Optum (UnitedHealth Group)
Category: Medical & Clinical Operations
Work Mode: Remote / Telecommute anywhere in the U.S. (must meet telecommuter policy)
Schedule: Full-time
Compensation / Salary: $20.00 – $35.72 per hour (based on experience, market, education, certifications)
Application Note: Posting may close early once a sufficient candidate pool is reached.


Job Summary

Optum is hiring an experienced Surgical Professional (Profee) Medical Coder to accurately code ICD‑10, CPT, and HCPCS for professional surgical services (with a focus on Plastics & Dermatology), ensure compliant charge capture, and drive denial management, reimbursement optimization, and TES edit resolution. Reporting to the Coding Manager, you’ll be the coding subject-matter resource for leaders and providers, leading focused reviews, education, and ongoing optimization across clinical areas—all in a fully remote setting.


Key Responsibilities

  • Charge capture & reconciliation: Review paper/electronic charge capture for completeness, accuracy, and correct linkage of ICD‑10, CPT, HCPCS & modifiers.

  • Productivity & timeliness: Clear pre‑billing edits within 2 business days; post charges within 4 days (OP) / 7 days (IP) of DOS; monitor Lag Time Reports.

  • Denial management: Process denials daily, correct coding to documentation, and meet all payer timelines.

  • Coding reviews & education: Conduct annual/focused reviews, orient new providers, and deliver targeted education based on coding trends.

  • Compliance: Adhere to AAPC/AHIMA Standards of Ethical Coding, CMS & OIG Official Coding Guidelines, medical necessity, bundling, and modifier rules.

  • Systems & tools: Use Epic EHR, MedAssets CodeCorrect, CodeRyte, and other coding applications; meet accuracy targets measured by TES edits, claim actions, and denials.

  • Continuous improvement: Track reimbursement and utilization trends; recommend updates to clinic sheets/charge documents to reflect ICD‑10, CPT, HCPCS changes.

  • Collaboration: Partner with Coding, Clinical Departments, HIM, IT, and Finance to resolve barriers and improve processes.


Required Skills & Qualifications

  • High School Diploma/GED (or higher).

  • Active AAPC/AHIMA credential (e.g., RHIA, RHIT, CCS, CCS‑P, CPC, CPC‑H)—maintained annually.

  • 3+ years of Professional Services Surgery coding (Plastics & Dermatology).

  • 3+ years working with CPT, HCPCS, ICD‑10, anatomy & physiology, and medical terminology.

  • 3+ years applying coding rules/regulations (medical necessity, bundling, documentation compliance, denials, charge capture).

  • Proven experience meeting productivity, TES edit, and denial KPIs.

  • Meets telecommuter requirements: private workspace, secure handling of PHI, and approved high‑speed internet.


Perks & Benefits

  • Hourly pay: $20.00 – $35.72 (FT, experience/market dependent).

  • Comprehensive benefits package, incentives & recognition programs.

  • Equity stock purchase plan & 401(k) contribution (eligibility applies).

  • Robust career development pathways across Optum & UnitedHealth Group.

  • Work‑from‑home flexibility under a structured telecommuter policy.


Company Description

Optum, part of UnitedHealth Group, combines technology, analytics, and deep clinical expertise to improve health outcomes and reimbursement integrity. Optum’s coding teams lead with compliance, accuracy, and data‑driven process improvement, helping providers and health systems optimize revenue cycle performance while improving care quality.


Work Mode: Remote / Telecommute (U.S.)


Call-to-Action

Are you an AAPC/AHIMA‑certified Surgical Profee coder with a strong track record in ICD‑10, CPT, HCPCS, TES edit resolution, and denial management? Apply now to join Optum and advance your coding career with a national leader in healthcare optimization.