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 advantages data and resources they need to feel their best Here you will find a culture guided by inclusion talented peers comprehensive benefits and career development opportunities Come make an impact on the communities we serve as you help us advance health optimization on a global scale Join us to start Caring Connecting Growing together Coder Functions Verifying the coding of the diagnosis evaluation and management procedures modifiers or other codes required for the completeness and accuracy of the record Review examine and verify component parts of medical records Ensure completeness and accuracy of billed service Consistency and completeness of coding using established CMS criteria and regulations Authorized signatures and patient identification to ensure all documents contain sufficient documentation to support the diagnosis and treatment administered and the results obtained are adequately described Review diagnosis therapeutic and diagnostic procedures supplies materials injections and drugs with International Classification of Diseases ICD10 Current Procedural Terminology CPT Heath Care Financing Administration Common Procedure Coding Systems HCPCS - all levels and any other coding classification systems that may be required Primary Responsibilities Validate the claim denial reason and logic in our internal claim processing platforms and confirm that the logic is correctly applied according to CMS coding policies including but not limited to NCCI Policy NCD LCD Medicare Claim Processing Manual From a Part C perspective we cannot use UHC payment policies unless there is a direct CMS source of truth to support Search for information in cases where the coding is complex or unusual Interpret appeal validate claim processing and tie th

📌 Senior Medical Coding Analyst (Hyderabad)
🏢 UnitedHealth Group
📍 Hyderabad