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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Medical and Clinical Operations



Approximate Salary:

Not Specified

Position Type:

Full Time

Coding Manager- San Francisco, CA or Telecommute

UHG - San Francisco, California

Posted: 11/15/2018

Who are we?  Optum360.  We’re a dynamic partnership formed by Dignity Health and Optum to combine our unique expertise.  As part of the growing family of UnitedHealth Group, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of revenue management services to health care providers nationwide.  
If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be.  It’s an opportunity to do your life’s best work.(sm)
Coding Manager is a regional position, responsible for the daily operations including planning, organizing, staffing, directing, and controlling all functions of the Coding, programs. Coding Manager will manage, oversee, and monitor the process for the coding operations, and direct, support, and educate the staff, interact with Compliance, QA,  and other professional and support staff to ensure quality and consistency of ICD-10, CPT, and documentation guidelines according to CMS regulations and the organization's Compliance Plan.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.  
Primary Responsibilities: 
  • Responsible for the day to day department administrative operations, monitoring that DNFB is at 1 day after suspense period 
  • Assigns accounts to coders as needed (high dollar, oldest) in order to maintain DNFB using available reports for distribution of accounts
  • Oversight of coding functions associated with CMS billing guidelines
  • Works closely with CDI staff to incorporate query processes into best coding practices
  • Ensure coding quality in regards to CPT, ICD-10 CM and PCS methodology, ensuring optimal quality and reimbursement within Federal and State regulations
  • Establish policies and implement changes
  • Coordination with other HIM operations managers, leads, and coordinators
  • Review departmental procedures and evaluate the effectiveness of personnel
  • Analyze denial and rejection reports and appeals whenever appropriate
  • Proactively provide information, direction, and updates relevant to coding to providers
  • Review patient medical records to assign codes for diagnoses, treatments, surgical procedures, and nonsurgical procedures for hospital services
  • Maintains a working knowledge of CPT and ICD-10 coding principles, governmental regulations, protocols and third-party requirements pertaining to billing and documentation
  • Ensures all services documented in the patient’s chart are coded with appropriate diagnoses and procedure codes. When services are not documented appropriately, seeks to attain proper documentation in a timely manner
  • Works with Revenue Integrity (Charging) and ancillary departments as needed for correct claim components
  • Reviews records to ensure compliance with coding and documentation guidelines and governmental requirements 
  • Escalates issues to Audit area as needed for further review
  • Conducts education to physicians as needed in order to clarify documentation requirements
  • Ensures maximum efficiency and reimbursement for properly documented services
  • Performs other related duties as assigned or requested in a professional manner
Opportunity to telecommute with some travel involved and work for a large Fortune 5 organization.


Required Qualifications:
  • 5+ years of experience in a Health Information Management department
  • 2+ years of management experience in acute care setting
  • 2+ years of coding experience
  • Proficient in Microsoft office
  • Ability to travel 25% to the San Francisco, CA area for meetings
  • Access to high speed cable or DSL internet and a home office
Preferred Qualifications:
  • 3+ years of experience managing a coding department in a 300+ bed, Acute Care hospital facility
  • Bachelor's degree in HIM (Health Information Management) or related field; sufficient experience may substitute for degree
  • RHIA (Registered Health Information Administrator)
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: RHIT, RHIA, CCS, Coding Manager, Coding Supervisor, HIM, ICD-10, San Francisco, California, CA, Telecommute, Telecommuting, Telecommuter

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