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Remote Optum Medical Coding Jobs in Delaware (NOW HIRING)

Lead Software Engineer

Newark, DE ยท On-site +1

$128K - $200K/yr

Review code and technical deliverables to ensure alignment with design standards and quality ... Ensure development processes align with medical device regulations and quality standards, including ...

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Remote Optum Medical Coding information

What is remote Optum medical coding?

Remote Optum medical coding involves reviewing clinical documents and assigning standardized codes for diagnoses, procedures, and services, all while working from a location outside a traditional office or hospital setting. Coders use their knowledge of medical terminology and coding systems like ICD-10, CPT, and HCPCS to ensure accurate billing and compliance with regulations. Working remotely for Optum, a healthcare services company, typically requires strong attention to detail, proficiency with coding software, and adherence to privacy standards. This role supports healthcare providers in processing claims and receiving proper reimbursement.

What are some common challenges faced by remote Optum medical coders, and how can these be managed effectively?

Remote Optum medical coders often encounter challenges such as maintaining focus in a home environment, keeping up with frequent coding updates, and effectively communicating with clinical teams virtually. To manage these, it's important to set up a dedicated workspace, stay current with training provided by Optum, and use collaboration tools (like secure messaging or video calls) to clarify documentation or coding questions with colleagues. Regular check-ins with your team and engaging in Optum's professional development opportunities can also help you stay connected and advance your skills.

What are the key skills and qualifications needed to thrive as a Remote Optum Medical Coder, and why are they important?

To thrive as a Remote Optum Medical Coder, you need a solid understanding of medical terminology, ICD-10 and CPT coding systems, and a relevant certification such as CPC or CCS. Familiarity with electronic health record (EHR) systems, coding software, and HIPAA compliance tools is typically required. Keen attention to detail, time management, and strong written communication are essential soft skills for accuracy and collaboration in a remote environment. These competencies ensure precise coding, regulatory compliance, and efficient reimbursement processes, which are critical for healthcare operations.

What is the difference between Remote Optum Medical Coding vs Remote Medical Billing?

AspectRemote Optum Medical CodingRemote Medical Billing
CertificationsCPMA, CPC, CCSCPB, CPC
Work EnvironmentHealthcare organizations, insurance companies, remoteHealthcare providers, billing companies, remote
Industry UsageWidely used in healthcare and insurance sectorsCommon in healthcare provider billing departments

Remote Optum Medical Coding involves reviewing medical records and assigning appropriate codes for billing and insurance purposes, requiring coding certifications. Remote Medical Billing focuses on submitting claims and following up on payments, often requiring billing-specific certifications. Both roles are remote, industry-specific, and essential for healthcare revenue cycle management, but they differ in daily tasks and certification requirements.

What are popular job titles related to Remote Optum Medical Coding jobs in Delaware? For Remote Optum Medical Coding jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Remote Optum Medical Coding jobs in Delaware look for? The top searched job categories for Remote Optum Medical Coding jobs in Delaware are:
What cities in Delaware are hiring for Remote Optum Medical Coding jobs? Cities in Delaware with the most Remote Optum Medical Coding job openings:
Nurse Practitioner (Per Diem)

Nurse Practitioner (Per Diem)

ComplexCare Solutions

Dover, DE โ€ข On-site, Remote

$2.4K - $10K/mo

Other

Retirement

Posted 23 days ago


Job description

Overview
Nurse Practitioner Per Diem
This position covers all zip codes in: Kent County, DE
ComplexCare Solutions (CCS) specializes in helping those in need by delivering high-value home and virtual assessments for health plans nationwide. We pride ourselves on our member engagement aimed towards evaluating current health status, gaps in care, potential health risks and care management opportunities with a focus on driving better clinical outcomes.
CCS, on behalf of SME Medical Delaware, P.A., is calling on Advanced Practice Providers that are passionate about helping their local communities. We care dearly about those whom we serve, and we need your help to make a difference in the lives of our members. Providers have the opportunity to spend a full hour with these members, which allows them to capture a comprehensive picture of that individual's personal needs and what is required to keep them in the home and out of the hospital.
Compensation:
  • Pay Range: $2,400.00 - $10,000.00 per month (Potential income) Earnings will vary based on completed assessments, state of residence, and business needs as there is no guarantee of visits or minimum income
  • In-home visit rate: $120 - $140 depending on state of residence
  • If available, our telehealth rate is $85 per completed assessment

Benefit:
This position is eligible to participate in a company 401K plan providing the opportunity to save for retirement through employee contributions. New hires will be automatically enrolled in the company 401(k) plan at a 3% contribution rate with the option to opt out.
Responsibilities
  • Knowledge of CMS Regulations and NCQA HEDIS Guidelines
  • Knowledge of Evidence-based Clinical Practice Standards: American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA), Familiarity with ICD-10 and CPT-4 coding practices
  • Complete comprehensive, accurate and thorough review of the assigned member population, including timely completion and submission of all required encounter documentation (paper or electronic)
  • Ensure that all pertinent and active medical conditions are documented in the medical record in a manner compliant with CMS/DHHS, Company policy, and client requirements
  • Support the physician/patient relationship and ensure timely and adequate communication, documentation of assessment findings, recommendations, need for additional services, emergency services required if necessary and need for follow up and timelines for follow up to primary care provider (PCP) and health plan as required
  • Make general recommendations to members intended to improve members' knowledge of their chronic condition(s), such as information concerning recommended testing
  • Address and close identified gaps in care (disease-specific or preventive)
  • Recognize emergent or urgent situations requiring escalation and take appropriate action as specified in company policies, and as determined by reasonable professional judgment and ethical professional practice standards; and
  • Perform, document and communicate results of Point of Care (POC) Testing
  • Maintain compliance with Company policies, procedures and mission statement
  • Adhere to all confidentiality and HIPAA requirements as outlined within the Company's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position
  • Fulfill those responsibilities and/or duties that may be reasonably provided for the purpose of achieving operational and financial success of the Company
  • Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function
  • On a monthly basis, be available for a minimum of 25 slots of availability per month (approximately 37 hours)
  • We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such
  • Other duties as assigned

Qualifications
  • Active un-encumbered license to practice nursing
  • ANCC or AANP board certification as a Nurse Practitioner or Clinical Nurse Specialist in Family, Adult, Gerontology or Emergency Medicine.
  • Maintains current CPR certification
  • Compliance, prior to hire, with recommended Healthcare Personnel Requirements for vaccinations and preventive testing:
    • Hepatitis B
    • Influenza
    • MMR: Measles, Mumps and Rubella
    • Pertussis, Tetanus and diphtheria and acellular pertussis (Tdap)
    • Varicella
    • Tuberculosis
  • Home Health exp a plus
  • Must be able to effectively communicate with elderly and chronically ill patients and families
  • Understanding of Medicare, Medicaid and Health Plan benefit structures beneficial
  • Ability to multitask
  • Excellent customer service skills
  • Bi-lingual or multi-lingual a plus
  • Ability to practice autonomously in a remote clinical environment, including independently conducting patient assessments, formulating evidence-based treatment plans, managing complex chronic conditions, and making sound clinical decisions without direct on-site supervision
  • Proficient with computer platforms, electronic health records (EHRs), secure messaging systems, and cloud-based documentation tools

This company utilizes E-Verify.
ComplexCare Solutions (CCS) is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. By embracing diversity, equity and inclusion we enhance our work environment and drive business success. ComplexCare Solutions (CCS) strives to reflect the diversity of the communities where we operate and of our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.