Bring us your experience, your head for strategy, your strength with relationships and your eye for opportunity. In return we offer an unmatched place to grow and develop your career among a richly diverse group of businesses driven by the power and stability of a leading health care organization. Come help us heal and strengthen the health care system as you do your life's best work.(sm)
The Coding Compliance Manager provides expert auditing services for inpatient and outpatient coding, evaluating correct assignment of CPT, HCPCs and ICD - 10 - CM / PCS codes to verify billing accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations and standards.
The Coding Compliance Manager will provide education to coders on audit results, utilize expertise to research and respond to challenging coding questions, develop and provide general coding education, and evaluate audit results to recommend corrective actions.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Perform coding compliance and quality audits in support of Optum360's Compliance Program and client expectations
- Analyze and interpret documentation from medical records
- Clearly document audit findings and calculate coding and billing error rates
- Provide feedback and education as appropriate depending on findings
- Articulate audit findings appropriate for audience. Prepares written audit reports summarizing audit findings and any corrective action necessary to mitigate risk
- Perform data analysis and participate in risk assessment activities that are integral to development of the annual Revenue Integrity coding audit plan
- Serve as an expert resource to research and respond to challenging coding questions
- Conduct adhoc coding and billing compliance audits as requested
- Assist client organization with internal or external Compliance reviews, including responding to Independent Review Organization findings, as applicable
- Participate in client meetings and / or calls
- Stay abreast of relevant LCDs, NCDs, billing and coding guidelines concerning the current areas of audit focus
- Research, develop and present education programs to physicians, coders and management as requested
- Conduct auditor peer review audits as requested
- Bachelor’s degree or equivalent experience
- American Health Information Management Association certification such as - RHIA / RHIT or CCS
- 7+ years of IP audit experience, combination of inpatient and outpatient preferred
- Highly knowledgeable and experienced in the areas of ICD - 10 - CM and PCS, CPT and HCPCS coding systems. Proficient across a wide range of services offered in the inpatient and outpatient setting.
- Extensive experience with various electronic health record systems
- Experience analyzing coding and billing data for patterns and trends
- Demonstrated ability to analyze potential compliance and quality concerns
- Proficient in Word and Excel
- Exceptional written and verbal communication skills to communicate in clear, concise terms to management at all levels including the ability to articulate complex regulatory information in layman's terms
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
*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 Keywords: CPT, ICD, code, data analysis, billing, compliance, revenue, integrity, audit, inpatient, telecommute, telecommuting, telecommuter