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Careers at UnitedHealth Group


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


United States

Postal Code:


Approximate Salary:

Not Specified

Position Type:

Full Time

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Onsite CDIS Risk Adjustment Coder - RN / LPN Preferred - Chicago / Lisle, IL

UHG - Lisle, Illinois

Posted: 09/8/2018

At Optum, we share what might be seen as a surprisingly simple goal: making the health system work better for everyone. We look for people who relentlessly push themselves to go farther. For these high performers, a position on a team at Optum, a business of UnitedHealth Group, is a natural fit. We offer more than the talent, resources and can-do culture - we offer a place to improve the lives of others while doing your life’s best work.(sm).
The Onsite Clinical Documentation Improvement Specialist (CDIS) is responsible for provider CDI program oversight and day to day CDI implementation of processes related to the concurrent review of the clinical documentation in the medical record of Complex Care Management / ISNP Members.   The goal of the CDIS oversight is to assess the accuracy, specificity, and completeness of provider clinical documentation, and to ensure the documentation explicitly identifies all clinical findings and conditions present at the time of service.  Through collaboration with APCs and Senior Leadership the CDIS conducts medical record documentation and coding quality reviews to ensure correct coding and documentation of encounter data for Risk Adjustment and Fee for Service product lines.   
*This position requires up to 80% travel within the Chicago / Lisle area.  When not traveling, Specialist is required to work onsite at the following location: 2441 Warrenville Rd | Suite 610 | Lisle, Illinois 60532*
Primary Responsibilities:
  • The onsite CDIS works directly in the field with their assigned provider teams; performing quality reviews onsite in the skilled nursing facilities, as well as collaborating program initiatives with the senior market leadership team in the corporate office 
  • Provides expert level review of submitted visit notes; identifies gaps in clinical documentation that require clarification for accurate code assignment to ensure the documentation accurately reflects the severity of the condition
  • Performs ONSITE concurrent coding quality reviews for provider charts as well as  other teams as needed
  • Evaluates documentation to ensure that diagnosis coding is supported and meets specificity requirements for accurate submissions
  • Queries providers regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation within the heath record
  • Provides face to face coaching and feedback and develops targeted education and training to provider teams to improve accuracy
  • Facilitate and provide ICD10-CM coding training, as it relates to HCC coding, as requested
  • Performs analysis of quality review outcomes and provides formal feedback to providers on a regularly scheduled basis
  • Develops relationships with clinicians and communicates guidelines and requirements of Risk Adjustment Payment System to ensure correct coding and documentation
  • Maintains a 95% quality audit accuracy rate  
  • Collaborates directly with Market Leadership to develop Risk Adjustment quality review work plan as determined by market initiatives 

Required Qualifications:
  • Undergraduate degree or significant equivalent work experience
  • Coding Certification from AAPC or AHIMA, (CPC, CPC-H, CPC-P, RHIT, RHIA, CCS, CCS-P, CRC)
  • 5 years of active coding experience with ICD diagnosis coding
  • 3 years of Risk Adjustment HCC Coding / Auditing experience
  • 2 years of experience in a coding auditor or educator function, providing feedback to coders and or other providers
  • Experience developing and delivering coding education / training to professionals such as physicians, nurses, nurse practitioners etc.    
  • Advanced understanding of medical terminology, pharmacology, body systems / anatomy, physiology and concepts of disease processes
  • Exemplary attention to detail and completeness with a thorough understanding of CMS regulations and thorough understanding of potential areas of risk for fraud and abuse in regards to coding and documentation
  • Proficiency with Microsoft Office applications to include Word, Excel, PowerPoint and Outlook
  • Ability to work core business hours in a corporate setting
  • Ability to travel greater than 50 miles 75% of the time
Preferred Qualifications:
  • Insurance knowledge
  • Spanish speaking  
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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)

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: CPC, CCS, CCS - P, or RHIT, coding, Medicare, risk adjustment, ICD10, ICD9, audit, quality, CMS, HCC, CRC, Certified risk coder, HCC, RN, LPN, SKILLED, SNF, Long-term care, inpatient, Chicago, IL, Lisle, IL, Illinois

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