Medical Coder

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Employer - UnitedHealth Group
Category - hospitals-health
Job title - Medical Coder

Job Description
Job Family Description
Positions in this family include those reposnsible for functions in areas such as health services, clinical services and delivery of
clinical care.
Job Function Description
Jobs in this function provide coding and coding auditing services directly to providers. This includes the analysis and translation of
medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
General Job Profile

Moderate work experience within own function.

Some work is completed without established procedures.

Basic tasks are completed without review by others.

Supervision/guidance is required for higher level tasks.
Job Scope and Guidelines

Applies knowledge/skills to activities that often vary from day to day.

Demonstrates a moderate level of knowledge and skills in own function.

Requires little assistance with standard and non-standard requests.

Solves routine problems on own.

Works with supervisor to solve more complex problems.

Prioritizes and organizes own work to meet agreed upon deadlines.

Works with others as part of a team.
Minimum Educational Background

High school education or equivalent experience.
Licenses and Certifications
Code Description
Functional Competencies

Leverage understanding of disease process to identify and extract relevant details and data within clinical documentation and
make determinations or identify appropriate medical codes

Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code
applicability, rules, and guidelines

Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary
services) to assign appropriate medical codes

Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes

Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information

Follow up with providers as necessary when responses to queries are not provided in a timely basis

Utilize medical coding software programs or reference materials to identify appropriate codes
MCD_Make Medical Coding Determinations B) Developing

Read and interpret medical coding rules and guidelines to make decisions (e.g., exclusions, sequencing, inclusions)

Apply post-query response to make final determinations

Make determinations on medical charting and take initiative to complete reviews independently to avoid delays in the process

Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical
code determinations.

Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing
medical records (e.g., charts, assessments, visits, encounters)

Resolve medical coding edits or denials in relation to code assignment
MCD_Maintain Medical Coding Quality Standards B) Developing

Provide information or respond to questions from medical coding quality audits

Perform medical coding audits to evaluate medical coding quality

Review medical coding audit results

Follow steps per agreement with medical coding audit results to resolve discrepancies

Provide resources and information to substantiate medica

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Job Location Bengaluru, Karnataka
Date Posted 09 Aug 2019
Employer Email --No Email
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