Senior Medical Coder

    • Farmington, CT

Position Description

ProHealth Physicians, part of OptumCare

If you want to get way ahead in your career, it makes sense to be with an organization's that's way ahead of the curve. Formed in 1997, ProHealth Physicians has grown to become Connecticut's leading primary care physician organization. With over 90 locations throughout the state of Connecticut, our family of primary care doctors and specialists care for more than 360,000 people statewide. In fact, ProHealth serves every county and provides roughly ten percent of the primary care delivered to patients in the state. We're leaders in thinking and in serving our communities. For instance, we're a C.M.S. approved Accountable Care Organization (ACO), covering over 30,000 Medicare patients associated with our community-based primary care providers. We're also nationally recognized as a NCQA Level III Medical Home. That kind of progressive leadership makes us perfect fit for OptumCare and UnitedHealth Group's expanding family of providers. This is a place where you can stay way ahead as you do your life's best work.(sm)

The address is to this location is 3 Farm Glen Rd. Farmington, CT

Primary Responsibilities:

  • Responsible for procedure and diagnostic coding of professional charges. Works closely with clinical department physicians and staff to ensure accurate and compliant coding and maximization of revenue through initial coding and appeals of payer rejections relating to coding.
  • Codes a variety of medical records using CPT, HCPCS and ICD-9/ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, ambulatory surgery center and other charges for physicians and other providers of professional billing.
  • Contacts providers or their representatives regarding inappropriate, incomplete or unclear coding.
  • Follows up on outstanding coding related receivables following standard Revenue Operations policy/procedure/process and based upon payer filing deadlines.
  • Initiates refunds when appropriate for all third party insurance receipts in accordance with governmental and insurance contract agreements.
  • Ensures appropriateness of payer rejections and denials for coding related reasons.
  • Contacts payers/governmental agencies regarding coding related denials and appeals as appropriate following established Revenue Operations policy/procedure/process.
  • Responds to coding related inquiries from providers and support staff and others as requested.
  • Must keep current of governmental and other payor coding and reimbursement rules and requirements.
  • Attends a variety of meetings, conferences, and seminars as required or directed.
  • Performs other similar and related duties as required or directed.


You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • High School graduate
  • Certified Coder - Billing and Coding
  • Two (2) or more years of progressive provider coding/training experience


Preferred Qualifications:

  • Certified or Eligible for certification: CPC, CCS-P, CCS, CPC-A, CPC-H
  • Demonstrated knowledge and experience in ICD-9&10, CPT and HCPCS coding or successful completion of related college course


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Job Keywords: Provider relations, Coder, medical coder, senior medical coder,Farmington, CT, Connecticut


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