Full-Time
Medical Coding Subject Matter Expert
IPDRG
Posted on 8/12/2026
UnitedHealth Group
10,001+ employees
Diversified insurer and health services platform
No salary listed
India
In Person
Bachelor's
 Medical, Clinical & Veterinary (1) |
|---|
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- A graduate or postgraduate education in Life Sciences or Allied Medicine, including BHMS, BAMS, BPT, dental, pharmacy, or nursing backgrounds.
- Certification as a medical coder through AAPC or AHIMA, with CCS, CPC, CPC-H, or CCS-P certification.
- At least 5 years of coding experience in the relevant IPDRG specialty.
- Thorough knowledge of medical terminology, human anatomy and physiology, and pathophysiology.
- Understanding of medication and dosage interpretation.
- Proficiency in English communication.
- Ability to provide proper and detailed feedback on errors and conduct or provide training based on error trends.
- Ability to participate in, conduct, or lead calibration sessions between subject matter experts, auditors, and trainers.
- Audit coded medical records using ICD-10 and CPT.
- Adhere to HIPAA regulations.
- Recognize, interpret, and evaluate inconsistencies, discrepancies, and inaccuracies in received medical data, and appropriately alert or query the responsible party, coder, or supervisor.
- Meet auditor quality and productivity standards and process deadlines or turnaround times.
- Educate coders through feedback on errors.
- Analyze and report error trends and conduct sessions on observed trends.
- Conduct, participate in, or lead calibration calls between subject matter experts, auditors, and trainers.
- Report malpractice identified while auditing coders.
- Educate coders on coding updates.
- Distinguish carefully between educational feedback and errors.
- Review rebuttals with integrity.
- Comply with employment contract terms, company policies and procedures, and company directives, including potential work-location, team, shift, flexibility, and work-environment changes.
UnitedHealth Group combines two platforms, UnitedHealthcare and Optum, to provide health insurance and health services. UnitedHealthcare offers medical, dental, and vision plans for individuals, employers, and government programs, including Medicare and Medicaid. Optum uses data, technology, and analytics to deliver pharmacy care, care management, and consulting to providers, payers, and government entities. The company earns revenue from insurance premiums and service fees, and aims to help people live healthier lives by expanding access to affordable, high-quality care and improving health outcomes through data-driven solutions.
Company Size
10,001+
Company Stage
IPO
Headquarters
Minnetonka, Minnesota
Founded
1980
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Simplify's Take
What believers are saying
- July 16, 2026 raised 2026 adjusted EPS guidance to $19.50-$20.00 after a strong quarter.
- July 13, 2026 Optum partnered with Anthropic, accelerating AI-driven administrative automation.
- United Health Foundation’s 2026 Tennessee health-hub expansion extends community programs through 2027.
What critics are saying
- August 7, 2026 investors sued over Change Healthcare cybersecurity, Medicare billing, and governance failures.
- August 17, 2026 IRS targeted 2017-2020 foreign-subsidiary transfers, risking back taxes and penalties.
- UnitedHealth expects 1.1 million Medicare Advantage enrollment losses in 2026, pressuring growth and margins.
What makes UnitedHealth Group unique
- UnitedHealthcare and Optum give UnitedHealth unmatched payer-provider leverage across U.S. care delivery.
- July 16, 2026 Q2 raised guidance while 86.7% medical care ratio showed pricing discipline.
- UnitedHealth received $3.9 billion in 2026 Medicare Advantage bonus payments, underscoring operating scale.
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Benefits
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Growth & Insights and Company News
6 month growth
↓ -7%1 year growth
↓ -7%2 year growth
↓ -7%UnitedHealth is trouncing the market in 2026. Is the stock still a buy? This recovery story is turning into a success story. By Adria Cimino - Sep 4, 2026 at 3:50AM EST Key points. * Headwinds weighed on UnitedHealth's earnings last year, but the company today is better managing challenges. * UnitedHealth recently lifted its full-year earnings forecast. * 10 stocks The Motley Fool, LLC like better than UnitedHealth Group" Last year, UnitedHealth Group's (UNH +0.32%) struggles with rising medical costs weighed significantly on earnings - and on stock performance. But the company has since put into place a plan to turn things around, and that plan has been bearing fruit. Though UnitedHealth's challenges haven't disappeared, the company is better navigating the current market, and efforts are paving the way for long-term growth. Earnings in the recent quarter, which surpassed estimates, confirmed this positive momentum. And investors haven't ignored this important turnaround story. They've piled into UnitedHealth shares, sending the stock to a 21% gain so far this year. Considering this market-beating performance, is the stock still a buy? Let's find out. The rising cost of medical care. So, first a quick look at the headwinds facing UnitedHealth - and its fellow health insurers. The rising cost of medical care is an issue that probably won't go away, and it hurt UnitedHealth last year, particularly since the company underestimated patients' use of medical services. But wisely, UnitedHealth decided to adapt its operations to better manage these higher costs moving forward. Efforts included dropping certain plans that were too costly, increasing premiums, and investing in artificial intelligence (AI) to gain efficiency. The idea is that, since it's unlikely medical care costs will drop, UnitedHealth today and into the future will be better prepared to operate in a high-cost environment. In the quarter, the company's efforts across benefit design and network curation drove better- than-expected results for its Medicare Advantage business. That said, UnitedHealth continues to face high costs across its commercial offerings, a trend that's impacting the entire industry. The company says recovery in commercial margins will be a focus "longer than originally anticipated." This will be a key point for investors to watch. UnitedHealth Group Premium Feature Moneyball Superscore ( 0.32 %) $ 1.28 Current Price Key data points. Market Cap Day's Range $ 395.30 - $ 405.16 52wk Range $ 255.97 - $ 461.62 Dividend Yield UnitedHealth increases its outlook. But, overall, UnitedHealth's moves so far have been successful, and that may be seen in the latest earnings figures. The company reported adjusted earnings per share of $6.38, up from $4.08 in the same period last year and surpassing analysts' expectations. Meanwhile, the company increased its full-year adjusted earnings per share outlook to the range of $19.50 to $20. That's up from the prior estimate of $18.25 or greater. Where to invest $1,000 right now. When its analyst team has a stock tip, it can pay to listen. After all, Stock Advisor's total average return is 983%* - a market-crushing outperformance compared to 212% for the S&P 500. They just revealed what they believe are the 10 best stocks for investors to buy right now, available when you join Stock Advisor. *Stock Advisor returns as of September 4, 2026. Importantly, the company's medical care ratio came down to 86.7% from 89.4% in the same period a year ago. This ratio measures the percentage of premiums spent on medical care. A lower number is better for the insurer financially, though regulatory limits mean this percentage shouldn't drop too low. Insurers generally aim for 80% to 85%. It's key to note that UnitedHealth operates two units, the UnitedHealthcare insurance business and the Optum health services business. This, along with the fact that UnitedHealth is the biggest U.S. health insurer, offers the company a solid moat or competitive advantage. It would be difficult for a rival to upset UnitedHealth's market position. Now, let's consider the stock's performance and whether this player still should be on your buy list. As mentioned, UnitedHealth stock has climbed in the double digits this year as investors tracked the company's progress over the past couple of quarters. This has driven an increase in valuation, with the stock trading at 20x forward earnings estimates, up from a low of around 15x earlier this year. But, this level is still much lower than the peak of more than 35x reached last year. UnitedHealth may not be dirt cheap, but it has demonstrated over the past year that its plan to address the challenge of higher healthcare costs is working. So, considering the company's efforts and progress so far and the full valuation picture, it remains reasonably priced. All of that means that UnitedHealth, even after recent gains, is a stock to buy and hold onto as this recovery story could deliver more good news over time. Should you buy stock in UnitedHealth Group right now? Before you buy stock in UnitedHealth Group, consider this: The Motley Fool Stock Advisor analyst team just identified what they believe are the 10 best stocks for investors to buy now... and UnitedHealth Group wasn't one of them. The 10 stocks that made the cut could produce monster returns in the coming years. Consider when Netflix made this list on December 17, 2004... if you invested $5,000 at the time of its recommendation, you'd have $2,230,785!* Or when Nvidia made this list on April 15, 2005... if you invested $5,000 at the time of its recommendation, you'd have $6,886,785!* Now, it's worth noting Stock Advisor's total average return is 983% - a market-crushing outperformance compared to 212% for the S&P 500. Don't miss the latest top 10 list, available with Stock Advisor, and join an investing community built by individual investors for individual investors. *Stock Advisor returns as of September 4, 2026.
AG Brown sues United Healthcare, Optum for defrauding maryland medicaid program. Maryland Attorney General Anthony Brown filed a lawsuit against UnitedHealth Group (also known as United Healthcare) and Optum, Inc., alleging they defrauded th |!| Baltimore
Humana taps physician executive as new chief medical officer. Healthcare DIVE August 20, 2026 Rebecca Pifer Parduhn Dr. Shantanu Nundy is joining the Kentucky-based insurer from health navigation company Accolade. Name: Dr. Shantanu Nundy Previous title: Executive vice president of care delivery and chief health officer, Accolade New title: Chief medical officer, Humana He's replacing Kate Goodrich, who served as CMO from 2022 to October 2025, when she left for a role in the health services division of Humana's rival insurer UnitedHealth. The CMO post has sat empty since. As CMO, Nundy will help design Humana's products, platforms and use of artificial intelligence with a clinical eye, according to the release. The executive comes to Humana from Accolade, a health navigation and care...
UnitedHealth faces investor lawsuit over security failures. Two groups of institutional investors filed an amended lawsuit against UnitedHealth Group, accusing the company of fraud, earnings manipulation, and years of ignored cybersecurity weaknesses that resulted in the largest healthcare data breach in U.S. history. The suit, filed in federal court on August 7, expands on earlier claims from 2024. It now alleges UnitedHealth rushed its acquisition of Change Healthcare, a claims processing subsidiary, while sidelining internal audits that flagged Medicare billing issues. The plaintiffs, a Rhode Island public pension fund and Länsförsäkringar Fondförvaltning AB, a Swedish asset manager, contend leadership misled investors and repurchased nearly $29 billion in shares while hiding misconduct. Board members accused of "historic" governance failures. The complaint describes systemic breakdowns, with former Change Healthcare executives serving as confidential witnesses. One witness, who worked as the company's director of risk management from 2017 to 2023, stated the post-deal integration was deliberately sped up to make separation "nearly impossible" if regulators blocked the transaction. The Department of Justice had challenged the deal in 2022, arguing it would reduce competition and increase health insurance costs. The challenge failed, and UnitedHealth completed the acquisition later that year. The rushed timeline, the suit claims, left critical cybersecurity gaps, including a weak firewall and missing multifactor authentication on Change's systems. Those oversights enabled the 2024 ransomware attack that exposed data of 190 million people and disrupted claims processing nationwide. The breach cost the company over $2 billion, according to the witness, and caused its stock price and net income to drop. Executives knew about the security weaknesses but took no action, the plaintiffs argue, even as risks grew. Medicare billing practices under scrutiny. The amended complaint also targets the company's Medicare operations. It alleges UnitedHealth submitted at least $200 million in unsupported diagnosis codes to the federal government. The suit claims Stephen Hemsley, the CEO and board chairman, supported eliminating an internal audit program that had uncovered the billing problems. "On their watch, the company built its industry-leading earnings on a foundation of systemic wrongdoing and illegality," the lawsuit states. It accuses UnitedHealth of defrauding Medicare, denying care to vulnerable patients, violating privacy laws, and suppressing competition. Similar allegations have surfaced in other lawsuits and federal investigations in recent years. A related claim alleges the company misrepresented its "firewall" protocol with Optum, another subsidiary, to address antitrust concerns. The initial suit argued data separation claims were misleading, though the amended version focuses on the Change Healthcare acquisition and its consequences. The lawsuit does not specify damages sought. The scale of the alleged misconduct - spanning cybersecurity failures, Medicare fraud, and shareholder deception - could expose the company to major legal and financial risks. A spokesperson declined to comment on the ongoing litigation. If the case proceeds, it may force a review of how UnitedHealth managed its acquisitions and internal controls. The breach at Change Healthcare already led to congressional hearings and demands for stricter oversight of healthcare data security. Insider accounts in the suit could push regulators to examine the company's practices more closely. The legal battle remains in early stages. The plaintiffs' next steps will depend on whether the court allows the case to proceed as a class action, which would let other shareholders join. The outcome could influence how corporate governance failures are litigated in healthcare, especially when acquisitions and cybersecurity overlap. UnitedHealth has not yet responded to the amended complaint. The case is pending in federal court.
UnitedHealth faces IRS probe over potential tax avoidance. IRS seeks to recoup taxes based on UnitedHealth's transfers to a foreign subsidiary. Aug. 17, 2026 Bob Herman is the author of Health Care Inc., an award-winning weekly newsletter about the business of health and medicine. The Internal Revenue Service is investigating UnitedHealth Group, with an initial probe determining the health care conglomerate underpaid taxes during a four-year period by funneling money through a foreign subsidiary. The IRS is "seeking to significantly increase taxable income" from 2017 through 2020 and may force UnitedHealth to pay more "for subsequent years after 2020," UnitedHealth revealed in a recent regulatory filing. UnitedHealth received the notices, which have not been reported, from the IRS in March. These types of audits from the IRS are exceedingly rare and focus on how big companies transfer profits within themselves. Given UnitedHealth's size as one of the five largest companies in the world by revenue, this examination likely involves substantial sums of money. Unpacking the business - and secretive inner workings - of the U.S. health care industry