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Optum Encoder Jobs (NOW HIRING)

The US Oncology Network

Coding Analyst

Richardson, TX · On-site

Utilize coding tools such as Optum Encoder and CMS guidelines. * Code with an accuracy of 95% or higher based on QA internal reviews. Qualifications The ideal candidate for the position will have the ...

The US Oncology Network

Coding Analyst

Richardson, TX · On-site

Utilize coding tools such as Optum Encoder and CMS guidelines. * Code with an accuracy of 95% or higher based on QA internal reviews. Qualifications The ideal candidate for the position will have the ...

The US Oncology Network

Coding Analyst

Richardson, TX · On-site

Utilize coding tools such as Optum Encoder and CMS guidelines. * Code with an accuracy of 95% or higher based on QA internal reviews. Qualifications The ideal candidate for the position will have the ...

The US Oncology Network

Coding Analyst

Richardson, TX · On-site

Utilize coding tools such as Optum Encoder and CMS guidelines. * Code with an accuracy of 95% or higher based on QA internal reviews. * Qualifications The ideal candidate for the position will have ...

CommonSpirit Health

$47.52 - $78.41/hr

Experience with various encoder and EMR systems (Optum eCAC, Solventum, EPIC, Cerner, Meditech) * Registered Nurse * Clinical Documentation Improvement Professional (CDIP) Preferred * Bachelors of ...

Northside Hospital Inc.

Coder, OP Oncology PRN

Atlanta, GA

$18.50 - $24.50/hr

Knowledge or various encoders (Optum, Clintegrity, Compliance 360 and 3M), to include knowledge of CAC system. PREFERRED: * Credentials from AHIMA or AAPC * Three years coding experience in ...

Northside Hospital Inc.

Coder, OP Oncology PRN

Atlanta, GA

$18.50 - $24.50/hr

Knowledge or various encoders (Optum, Clintegrity, Compliance 360 and 3M), to include knowledge of CAC system. PREFERRED: * Credentials from AHIMA or AAPC * Three years coding experience in ...

Northside Hospital Inc.

Coder, OP Oncology PRN

Atlanta, GA

$18.50 - $24.50/hr

Knowledge or various encoders (Optum, Clintegrity, Compliance 360 and 3M), to include knowledge of CAC system. PREFERRED: * Credentials from AHIMA or AAPC * Three years coding experience in ...

Northside Hospital Inc.

Coder, OP Oncology PRN

Atlanta, GA · On-site

$18.50 - $24.50/hr

Knowledge or various encoders (Optum, Clintegrity, Compliance 360 and 3M), to include knowledge of CAC system. PREFERRED: * Credentials from AHIMA or AAPC * Three years coding experience in ...

UTMB Health

Senior Coder - RCO Coding (Remote)

Galveston, TX · Remote

$21.50 - $28.50/hr

Utilizes the encoder and/or Optum software to correctly assign all appropriate ICD-10-CM, ICD10-PCS and CPT codes for diagnosis and procedures. * Sequences diagnoses and procedures to generate clean ...

UTMB Health

Senior Coder - RCO Coding (Remote)

Galveston, TX · On-site +1

$21.50 - $28.50/hr

Utilizes the encoder and/or Optum software to correctly assign all appropriate ICD-10-CM, ICD10-PCS and CPT codes for diagnosis and procedures. * Sequences diagnoses and procedures to generate clean ...

UTMB Health

Senior Coder - RCO Coding (Remote)

Galveston, TX · Remote

$21.50 - $28.50/hr

Utilizes the encoder and/or Optum software to correctly assign all appropriate ICD-10-CM, ICD10-PCS and CPT codes for diagnosis and procedures. * Sequences diagnoses and procedures to generate clean ...

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All JobsOptum Encoder Jobs

Optum Encoder information

See salary details

$57

$79

$96

How much do optum encoder jobs pay per hour?

As of Jul 8, 2026, the average hourly pay for optum encoder in the United States is $79.54, according to ZipRecruiter salary data. Most workers in this role earn between $62.50 and $96.15 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as an Optum Encoder, and why are they important?

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 Optum Encoders?

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 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.
More about Optum Encoder jobs
What cities are hiring for Optum Encoder jobs? Cities with the most Optum Encoder job openings:
What states have the most Optum Encoder jobs? States with the most job openings for Optum Encoder jobs include:
What job categories do people searching Optum Encoder jobs look for? The top searched job categories for Optum Encoder jobs are:
Optum Encoder jobs near you
Infographic showing various Optum Encoder job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 1% As Needed, 88% Full Time, 6% Part Time, 1% Temporary, and 3% Contract. Highlights an 73% Physical, 1% Hybrid, and 26% Remote job distribution, with an average salary of $165,436 per year, or $79.5 per hour.
Business Analyst (Policy remediation) - Contract - Remote

Business Analyst (Policy remediation) - Contract - Remote

SUNSHINE ENTERPRISE USA LLC

Columbia, SC • On-site, Remote

Contractor

Posted 10 days ago

Job description


Business Analyst (Policy remediation)
Location: Remote
Interview Process: 1 round, virtual
Duration: 12 MonthsEmployment Type: ContractExperience Required: 05+ Years
Candidate Location: Candidate MUST be a SC resident. No relocation allowed.
Project Scope:
We are seeking an experienced Business Analyst with expertise in policy remediation, medical coding, and healthcare claims systems. This role will serve as a subject matter expert (SME) supporting policy and operational initiatives related to medical coding compliance, claims adjudication, and system change management.
The ideal candidate will leverage deep knowledge of ICD-10, CPT, and HCPCS coding methodologies, as well as Medicaid and payer operations, to ensure alignment between policy updates, coding changes, and system functionality. This position will play a critical role in supporting compliance initiatives, regulatory updates, and business process improvements.
Key Responsibilities:
• Serve as a subject matter expert (SME) for medical coding methodologies, Medicaid policy, and claims adjudication processes.
• Analyze annual, quarterly, and ad hoc coding updates, including ICD-10, CPT, and HCPCS changes.
• Review and assess the impact of coding and policy changes on business processes, system functionality, and claims outcomes.
• Collaborate with business stakeholders, policy teams, and technical teams to define requirements and implement necessary system changes.
• Support change requests and ensure system updates produce accurate and expected claims adjudication results.
• Research business rules, requirements, and process models to develop recommendations and solutions.
• Maintain and update business rules, requirements documentation, and process models in designated repositories.
• Lead meetings with stakeholders, business owners, and cross-functional teams.
• Participate in policy remediation efforts, compliance initiatives, and related enterprise projects.
• Ensure process documentation, training materials, and supporting documentation are complete and up to date.
• Collaborate with internal teams to support ongoing operational and regulatory compliance.
• Provide expertise in medical coding software, claims systems, and healthcare policy interpretation.
Required Skills & Experience:
• Minimum of 5 years of experience in healthcare insurance, medical review, program integrity, or appeals.
• At least 5 years of experience working with IT developers and programmers in a payer environment.
• Minimum of 5 years of hands-on experience in medical coding within a payer environment.
• Strong expertise in ICD-10, CPT, and HCPCS coding methodologies and translation.
• Minimum of 5 years of experience with medical claims processing systems.
• Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint).
• Experience using Optum Encoder or similar medical coding software.
• Strong analytical, problem-solving, and critical-thinking skills.
• Excellent written and verbal communication skills.
Preferred Skills:
• Minimum of 5 years of experience in policy remediation.
• At least 3 years of clinical experience in a healthcare environment.
• Strong clinical assessment and critical-thinking skills.
• Experience with Medicaid programs and Medicaid Management Information Systems (MMIS).
• Familiarity with healthcare regulatory compliance and policy implementation.
Technical Skills
Medical Coding and Reimbursement, ICD-10, CPT, and HCPCS Expertise, Policy Remediation and Compliance, Claims Adjudication and Processing, Medicaid and MMIS Knowledge, Business Requirements Analysis, Process Documentation and Improvement, Stakeholder Engagement and Facilitation, Regulatory and Operational Compliance, Cross-Functional Collaboration
Education:
Bachelor's degree in Health Information Management, Healthcare Administration, Business, or a related field.

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