6 days old

Senior Medical Coder - 932102

Albuquerque, NM 87102
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  • Job Code
    932102

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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Evaluates Risk Adjustment coding from medical records to ensure accurate coding of encounter data and recommends processes to ensure accurate and efficient coding practices. Assists in providing feedback regarding coding and reimbursement. Participate in operational activities. Work with network managers, medical director, market leader, stakeholders, and other employees to ensure improvement in coding accuracy. Position maintains high level (96%) coding accuracy and completes work within assigned queue in established timeframe. Performs coding querying, adds missed codes. Identifies deletes, code validation, identifies suspects.

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Youll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

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Primary Responsibilities:

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  • Leverage understanding of disease process to identify and extract relevant details and data within clinical documentation and make determination or identify appropriate ICD-10 &/or CPT codes following CMS guidelines
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  • Evaluates documentation to ensure that diagnosis coding is complete, supported, and meets specificity requirement to support clinical indicators, HEDIS and STARS quality measures, as required by client
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  • Identifies suspect / unreported HCC codes in the notes / records to reflect the severity of the patient's condition
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  • Performs level one concurrent or retrospective coding quality reviews
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  • Queries providers regarding missing, unclear, or conflicting health record documentation through the use of approved templates consistent with Optum Coding Guidelines
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  • Resolve medical coding edits or billing item rejects in relation to code assignment
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  • Work with assigned providers, network managers, medical director, market leader, stakeholders and/or other employees to ensure improvement in provider coding accuracy, as necessary
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  • Performs the minimum number of coding quality reviews consistent with established departmental goals
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  • Maintains a 96% quality audit accuracy rate
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Youll 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.

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Required Qualifications:

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  • High school diploma or GED equivalent
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  • Coding Certification from AAPC or AHIMA professional coding association (CPC, RHIT, RHIA, CCS, CRC)
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  • 3+ years of experience in ICD-10-CM or 2 years minimum experience in HCC Coding
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  • Knowledge of CMS Risk Adjustment and HCC Coding process
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  • Working knowledge of CPT / Evaluation and Management guidelines
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
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  • Proven attention to detail
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  • Ability to perform in a deadline driven environment
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  • Ability to maintain professionalism and a positive service attitude at all times
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  • Proven verbal / written communication and interpersonal skills
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  • Ability to analyze facts and exercise sound judgment when arriving at conclusions
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  • Ability to effectively report deficiencies with a recommended solution in oral and/or written form
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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)

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Colorado Residents Only: The hourly range for Colorado residents is $20.77 to $36.88. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, youll find a far-reaching choice of benefits and incentives.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

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

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Job keywords: Senior Medical Coder, Sr Medical Coder, Medical Coding, Coder, HCC, Hierarchical Condition Category Coding, Revenue, Risk Adjustment Coding, ICD-10, Clinical Performance, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Albuquerque, NM, New Mexico

Posted: 2021-06-08 Expires: 2021-07-08

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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Senior Medical Coder - 932102

UnitedHealth Group
Albuquerque, NM 87102

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