Job details
Job type full-time
Full job description
Telecommute with restrictions: this position will primarily work remotely, but candidates must be located within central indiana (indianapolis market preferred) as occasional travel to american health network, part of optum medical practices is required.
Optumcare is a rapidly growing national, integrated health care organization that helps physicians and other providers deliver the right care at the right time in the right settingWe design and manage delivery systems in markets where we can achieve the quadruple aim — a better patient experience, higher quality care, lower costs, and a better experience for providersWith our expertise and resources, we are on the front lines transforming the health care delivery system to help improve the overall health of patients and communities.
This physician led, patient centric, and data driven business creates value by delivering and facilitating care across the full continuum through high performing networks comprised of owned, managed and contracted physicians, advanced practitioners and other providersOur system impact extends across physicians, specialty care, urgent care, home health, post-acute transitions, complex care in skilled nursing facilities and palliative care.
Job summary:
This position is responsible for prospective and retrospective review of the electronic health record (ehr) to assist providers in more specific and complete documentation and codingThrough interaction with the physicians and other clinicians, this role facilitates improvement in the quality, completeness, and accuracy of the medical record documentation to support severity of illness, medical necessity, risk adjustment factor and level of services rendered.
Primary responsibilities:
Conducts concurrent reviews of selected patient records to address clarity, completeness, consistency, and precision of clinical documentation
Demonstrates understanding of clinical documentation requirements to ensure that the severity of illness, risk of mortality, and services provided are accurately reflected in the record
Serves as a resource on appropriate clinical documentation to support the coded conditions and risk adjustment factors
Communicates documentation discrepancies and coding definitions to the physicians both written and verbally as needed to clarify clinical documentation in accordance to query standards and/or policies
Conduct 1:1 educational sessions with physicians and other healthcare team members related to specific documentation and coding requirements
Collaborates and educates he multi-disciplinary team, including physicians, nurse practitioners, physician assistants, executive directors, practice managers, coding/billing staff and others regarding clinical documentation and coding best practices
Utilizes the electronic health record effectively
Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints
Participates in quality and performance improvement activities
Attends meetings and participates on committees as requested
Reviews current literature and attends training sessions and seminars to keep informed of new developments in the field and to maintain certification
Performs other related duties and responsibilities as 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:
Certified professional coder (cpc) or certified coding specialist–physician (ccs-p)
At least 2+ years of coding experience in physician-based settings (physician offices or group practices) or in the payer environment
Preferred qualifications:
Certified risk adjustment coder (crc)
Knowledge of anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses
Expertise in reviewing and assigning accurate medical codes for diagnoses performed by physicians and other qualified healthcare providers in the office setting
Sound knowledge of medical coding guidelines and regulations
Expert in icd-10 diagnosis coding
A keen understanding of the impact of diagnosis coding on risk adjustment payment models
Apply proper diagnosis code assignment under various risk adjustment models including hcc, cdps, aca-hhs and private payer models
Understand the use of data mining from data captured through risk adjustment coding
Understand predictive modeling from data captured through risk adjustment coding
Ability to identify and communicate documentation deficiencies to providers to improve documentation for accurate risk adjustment coding
Expert knowledge in health information documentation, data integrity, and quality
*all telecommuters will be required to adhere to unitedhealth group`s telecommuter policy.
Proof of immunity to vaccine-preventable diseases is an employment requirement.
Unitedhealth group requires all new hires and employees to report their covid-19 vaccination status.
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.
Unitedhealth group is a drug-free workplaceCandidates are required to pass a drug test before beginning employment.
Job keywords: coding quality analyst, medical coding analyst, certified professional coder, certified coding specialist, certified risk adjustment coder, indianapolis, indiana
