1+ months

Certified Coding Specialist- Denver, CO

Denver, CO 80204
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Opportunities with New West Physicians. Bring your passion for health care to New West Physicians in Colorado, a team committed to providing excellent service to every patient… every time. We’re not only one of the largest physician groups in Colorado with 21 offices throughout the Denver Metro area - we’re also part of Optum, a nationwide family of nearly 45,000 dedicated physicians working together to help people live their healthiest lives. That means we’re backed by the resources of a global health care organization working to help people live healthier lives and help make the health system work better for everyone. For four consecutive years, New West Physicians achieved Elite status - the highest ranking - in the America’s Physician Groups Standards of Excellence Survey. In addition, New West Physicians was selected as one of the 2017 Million Hearts® Hypertension Control Champions by the Centers for Disease Control and Prevention, and was the 2015 recipient of AMGA's National Acclaim Award recognizing high performing medical groups bringing the American health care system closer to the ideal delivery model: one that’s safe, effective, patient-centered, timely, efficient, and equitable. It’s all possible because of our highly qualified, board-certified family practice and internal medicine physicians, hospitalists, cardiologists, gastroenterologists, psychiatrists, endocrinologists, neurologists, physician assistants, nurse practitioners and more. If this sounds like the place for you, it’s time to take a closer look at New West Physicians and discover a path to your life’s best work.(sm)


Only candidates located in the greater Denver, CO area will be considered. 



Review documentation to assure proper application of ICD-10 coding guidelines and policies. Application of appropriate CPT, CPTII, HCPCS, and modifiers necessary for accurate charge submission and reimbursement. Maintain defined charge submission turnaround times. Query providers for documentation clarification. Communicate with providers and clinic staff on a regular basis regarding documentation, coding and billing related issues.


Primary Responsibilities:


  • Performs concurrent review of provider documentation, diagnoses and charge codes for Medicare Advantage members for assigned providers or sites to ensure proper ICD-10, CPT, CPTII, HCPCS and modifiers are applied
  • Query providers or clinic staff as necessary for clarification of documentation or lack thereof as it pertains to proper application of ICD-10 HCC diagnosis codes
  • Reviews additional chart details and documentation as necessary to ensure proper diagnoses codes are applied; including reviewing orders, pathology, radiology, labs and other test results
  • Responsible for identifying/extracting any additional documented HCC diagnosis not coded by provider for reviewed encounter
  • Will work out of multiple systems including: Touchworks EHR, Allscripts PM and DataRaps applications
  • Conducts physician chart audits for HCC coding as requested (includes research and presentation of finding and correct coding principles)
  • Expected to maintain a coding accuracy level of 95%
  • Maintains turnaround times as defined by Manager
  • Assists billing office staff with claims denials and corrections for re-billing purposes as needed
  • Conducts training sessions for physicians on relevant topics or updates, such as documentation guidelines, Medicare/Medicaid regulations, and documentation and coding requirements for HCC/risk adjustment
  • Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10 CM, CPT, and HCPCS II materials
  • Performs other miscellaneous duties as required



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.

Posted: 2020-09-10 Expires: 2020-11-12

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Certified Coding Specialist- Denver, CO

UnitedHealth Group
Denver, CO 80204

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