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Optum Care Delivery
Las Vegas, NV, United States (on-site)
18 days ago
Northern Nevada Medical Center
Sparks, NV, United States (on-site)
30+ days ago
Optum Care Delivery
Las Vegas, Nevada, United States (on-site)
18 days ago


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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

Evaluates clinical 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. Train Coders, educate providers, perform audits.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
  • 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
  • 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
  • Identifies suspect/unreported HCC codes in the notes/records to reflect the severity of the patient's condition
  • Performs concurrent or retrospective coding quality reviews
  • Queries providers regarding missing, unclear, or conflicting health record documentation through the use of approved templates consistent with Optum Coding Guidelines
  • Resolve medical coding edits or billing item rejects in relation to code assignment
  • Work with assigned providers, network managers, medical director, market leader, stakeholders and/or other employees to ensure improvement in provider coding accuracy, as necessary
  • Performs the minimum number of coding quality reviews consistent with established departmental goals
  • Train/audit new coders in accordance with Optum and Official Coding Guidelines
  • Provide targeted education and training to provider groups/teams
  • Maintains a 96% quality audit accuracy rate

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 diploma or GED equivalent
  • Coding Certification from AAPC or AHIMA professional coding association (CPC, RHIT, RHIA, CCS, CRC)
  • 5+ years of experience in ICD-10-CM or 2 years minimum experience in HCC Coding
  • 2+ years of experience in provider education experience - communicating directly with providers
  • Knowledge of CMS Risk Adjustment and HCC Coding process
  • Working knowledge of CPT/Evaluation and Management guidelines

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

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

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)

Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $21.68 to $38.56. The hourly range for Connecticut / Nevada residents is $23.94 to $42.40. 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, you’ll find a far-reaching choice of benefits and incentives.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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 workplace. Candidates are required to pass a drug test before beginning employment.

Job Information

  • Job ID: 66654460
  • Workplace Type: On-Site
  • Location:
    Las Vegas, Nevada, United States
  • Company Name For Job: Optum Care Delivery
  • Position Title: Senior Medical Coder - Telecommute
  • Setting: Other
  • Job Function: Any
  • Job Type: Full-Time

Please refer to the company's website or job descriptions to learn more about them.

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