Optum · 2 months ago
Profee Auditor
Owensboro, KY
Full-time
Hybrid
Mid Level
$28.27/hr - $50.48/hr
3+ years expOptum is a healthcare company that aims to improve health outcomes in the communities it serves. The Profee Auditor will assess and interpret the needs of the Ambulatory Coding Team, manage coding duties, and provide education to the coding staff and clients, ensuring adherence to coding guidelines.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Assesses and interprets the needs of the Ambulatory Coding Team by prioritizing work to meet deadlines. This can include assisting with coding duties and managing work queues
Identifies solutions to non-standard edits, workflows and issues
Solves complex questions and conducts analysis of trends to provide education for the coding staff and clients including physicians/providers
Provides detailed education to the Coding Team and acts as a resource to others
Apply expert coding knowledge to professional coding and billing initiatives and inquiries
Identify appropriate assignment of ICD-10-CM, CPT, and HCPCS II Codes for physician services, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
Adhere to the ethical standards of coding as established by AAPC and/or AHIMA
Adhere to and maintain required levels of performance in both coding quality 95% and productivity as established by Optum360
Understand the federal coding register and ensure guidelines are used and followed appropriately
Understanding of the appeal process with knowledge how to speak to denial and/or appeals
Provide documentation feedback to providers and query physicians when appropriate
Maintain up-to-date Coding knowledge by reviewing materials disseminated/recommended by Compliance, Coding Operations, etc
Participate in coding department meetings and educational events
Strong knowledge of coding clinics and how to obtain education information
Assist in rebills as appropriate
Other duties at the discretion of the VP & management
Qualification
Required
High School Diploma/GED (or higher)
Professional coder certification with credentialing from AHIMA and/or AAPC (CPC, CCS-P, RHIA, RHIT) to be maintained annually
3+ years of experience with physician medical coding, including surgical and/or specialty specific coding in a multi-specialty physician group
Intermediate level of proficiency with a PC in a Windows environment, including Microsoft Excel (filter, sort, edit)
Ability to work full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 4:30pm. It may be necessary, given the business need, to work occasional overtime
Must be 18 years of age OR older
Preferred
3+ years of experience in E/M coding (both IP and OP), surgical and specialty specific coding
Experience auditing charts in a professional coding environment
Experience providing physician/coding education
Experience with various systems (EPIC, Encoder Pro)
Expert level of proficiency with coding guidance to physicians, practitioners and coders as needed
Intermediate level of knowledge of OCE, MUE and NCCI classification and reimbursement structure
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
Company data provided by crunchbase