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Optum Encoder Jobs in Illinois (NOW HIRING)

PB Coding Coordinator

Springfield, IL · On-site

$31.01 - $48.84/hr

Functionally work within Microsoft Office Suite products & Optum Encoder Pro. * Provides education/training for medical providers and coders within the department. * Performs quality assurance audits ...

PB Coder

Springfield, IL · On-site

$28.06 - $44.20/hr

Microsoft Office Suite products, Kronos, ServiceHub, Optum Encoder Pro, etc.). * Meets or exceeds productivity standards. * Participates in continuing education programs to maintain an understanding ...

Inpatient Medical Records Coder

New Lenox, IL · On-site +1

$25.84 - $38.76/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

MS-DRG knowledge required, APR-DRG knowledge a plus * 2 - 3 years of Acute Care Hospital Coding experience required * 3M Encoder experience preferred, Cerner, Meditech, Optum System experience ...

Optum Encoder information

What is an Optum Encoder?

Optum Encoders are specialized healthcare professionals who use Optum's medical coding software to accurately translate clinical documentation into standardized medical codes. These codes are used for billing, insurance claims, and maintaining patient records. Optum Encoders play a critical role in ensuring that healthcare providers receive proper reimbursement and comply with regulatory requirements. They must be knowledgeable about medical terminology, coding guidelines, and healthcare regulations. Their work helps streamline administrative processes and improve data quality in the healthcare industry.

What are the key skills and qualifications needed to thrive as an Optum Encoder?

To excel as an Optum Encoder, you need a solid understanding of medical coding systems (such as ICD-10, CPT, and HCPCS) and typically a certification like CPC or CCS. Familiarity with Optum’s 3M Encoder software, electronic health records (EHRs), and hospital information systems is also crucial. Attention to detail, analytical thinking, and effective communication are vital soft skills for ensuring coding accuracy and collaborating with clinical and billing teams. These abilities are important to ensure precise coding, regulatory compliance, and optimal reimbursement for healthcare services.

What are some common challenges faced by Optum Encoders when working with complex medical records?

Optum Encoders often encounter challenges such as interpreting incomplete or ambiguous clinical documentation, keeping up-to-date with evolving coding standards, and ensuring high levels of accuracy under tight deadlines. Collaboration with healthcare providers and coding auditors is frequently required to clarify information and resolve discrepancies. Staying detail-oriented and proactive in seeking clarification helps maintain compliance and reduce errors, while also providing opportunities to learn and grow in the role.

What is the difference between Optum Encoder vs Medical Coder?

AspectOptum EncoderMedical Coder
CertificationsTypically requires coding certifications like CPC or CCSOften requires CPC, CCS, or similar certifications
Work EnvironmentHealthcare facilities, insurance companies, remote optionsHospitals, clinics, insurance companies, remote work common
Industry UsageUsed mainly in healthcare and insurance sectorsWidely used across healthcare providers and insurance
Job ResponsibilitiesEncoding medical records for billing and documentationAssigning standardized codes to medical diagnoses and procedures

Both Optum Encoder and Medical Coder roles involve medical coding, often requiring similar certifications and working in healthcare environments. While Optum Encoder may be specific to Optum's systems and processes, Medical Coder is a broader role found across many healthcare organizations. Understanding these similarities helps in choosing the right career path or job search focus.

What cities in Illinois are hiring for Optum Encoder jobs?

Cities in Illinois with the most Optum Encoder job openings:

PB Coding Coordinator

Intermountain Health

Springfield, IL • On-site

$31.01 - $48.84/hr

Other

Posted 4 days ago


Intermountain Health rating

7.2

Company rating: 7.2 out of 10

Based on 843 frontline employees who took The Breakroom Quiz

350th of 887 rated healthcare providers


Job description

Job Description:

Accurately evaluate and resolve coding edits in assigned Epic WQs and review documentation and assign appropriate CPT, HCPCS, ICD-10 codes and modifiers as applicable.

Essential Functions

  • Effectively navigate Epic EMR, including applicable reports and work queues.

  • Accurately evaluate and resolve coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic.

  • Review medical record documentation and assign appropriate CPT, HCPCS, ICD-10, and modifiers.

  • Effectively evaluate coding bundling guidelines and modifier usage.

  • Understand the Medicare Physician Fee Schedule

  • Communicate coding/denial trends and provider education opportunities to coding leadership.

  • Communicate effectively with providers via Epic in-basket message and email.

  • Functionally work within Microsoft Office Suite products & Optum Encoder Pro.

  • Provides education/training for medical providers and coders within the department.

  • Performs quality assurance audits within specialty team.

  • Ensures compliance with coding regulations and guidelines pertaining to specialty area and assists the leadership team in crafting communications, tip sheets and workflows as needed. Monitors and evaluates coding workflows in order to identify opportunities for improvement.

  • Utilizes coding knowledge and source-based research to investigate and respond to coding requests related to their specialty area, as needed.

  • Promotes mission, vision, and values of Intermountain Health, and abides by service behavior standards.

  • Performs other duties as assigned.

Skills

  • CPT, HCPCS, ICD-10 coding

  • Prior Epic/PB Resolute experience

  • Microsoft Office suite

Qualifications

  • High School Diploma or equivalent, required

  • Minimum of five (5) years of pro fee coding experience with at least three (3) years within assigned specialty service line

  • Preferred seven plus (7+) years of related coding experience

  • Required credential: CPC Certified Professional Coder (CPC) or Certified Coding Specialist Physician (CCS-P)

  • Preferred related specialty coding credential

  • Requires E/M (Evaluation & Management) coding and experience coding for the assigned specialty specific service line

  • Prefer previous experience using Epic and working work queues

Physical Requirements

  • Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.

  • Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.

  • Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.

Location:

Lake Park Building

Work City:

West Valley City

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$31.01 - $48.84

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here (https://intermountainhealthcare.org/careers/benefits) .

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.


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