1+ months

Certified Coding Specialist - Denver, CO

Denver, CO 80204
  • Job Code

Opportunities with New West Physicians. Bring your passion for health care to New West Physicians in Colorado, a team committed to providing excellent service to every patient€ every time. We're not only one of the largest physician groups in Colorado with 21 offices throughout the Denver Metro area - we're also part of Optum, a nationwide family of nearly 45,000 dedicated physicians working together to help people live their healthiest lives. That means we're backed by the resources of a global health care organization working to help people live healthier lives and help make the health system work better for everyone. For four consecutive years, New West Physicians achieved Elite status - the highest ranking - in the America's Physician Groups Standards of Excellence Survey. In addition, New West Physicians was selected as one of the 2017 Million Hearts Hypertension Control Champions by the Centers for Disease Control and Prevention, and was the 2015 recipient of AMGA's National Acclaim Award recognizing high performing medical groups bringing the American health care system closer to the ideal delivery model: one that's safe, effective, patient-centered, timely, efficient, and equitable. It's all possible because of our highly qualified, board-certified family practice and internal medicine physicians, hospitalists, cardiologists, gastroenterologists, psychiatrists, endocrinologists, neurologists, physician assistants, nurse practitioners and more. If this sounds like the place for you, it's time to take a closer look at New West Physicians and discover a path to your life's best work.(sm)


Only candidates located in the greater Denver, CO area will be considered. 


The Certified Coding Specialist will review documentation and attestation responses of IPA providers for complete and accurate application of HCC diagnoses to the greatest level of specificity. Extract and confirm additional HCC diagnoses supported within documentation. Maintain defined turnaround times and productivity expectations. Communicate with IPA, CMO, and IPA providers on a regular basis regarding documentation and HCC coding related issues.

Primary Responsibilities:


  • Perform retro reviews of provider documentation and associated attestation to ensure documentation supports HCC diagnosis designations.
  • Extract additional documented and confirmed HCC diagnoses for dos as appropriate.
  • Work closely with physicians, IPA team, and other integral parties to uncover and discuss coding analysis results.
  • Identify provider documentation and coding trends to highlight opportunities for improvement as it relates to risk/HCC coding. Includes research, reporting and presentation.
  • Support IPA team members, and RAF Physician Champion as needed to provide review details and reporting on specific providers underutilizing attestation program.
  • Query providers or clinic staff as necessary for clarification of documentation or lack thereof as it pertains to proper application of ICD-10 HCC diagnosis codes.
  • Reviews additional chart details and documentation as available to ensure proper diagnoses codes application; including reviewing orders, pathology, radiology, labs and other test results.
  • Will work out of multiple systems including: Touchworks EHR, Allscripts PM, BISCOM and DataRaps applications
  • Expected to maintain a coding accuracy level of 95%.
  • Maintains turnaround times as defined by Manager.
  • Conducts training sessions for physicians on relevant topics or updates, such as documentation guidelines, Medicare/Medicaid regulations, and documentation and coding requirements for HCC/risk adjustment as requested.
  • Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10 CM, CPT, and HCPCS II materials.
  • Enhances professional growth and development through in-service meetings, educational programs, conferences, etc.
  • Will utilize coding tools provided, ICD-10, CPT, HCPCS books, and Encoder pro to perform accurate coding.
  • Will meet productivity expectations and provide Manger with weekly productivity report.
  • Will follow all CDO and OptumCare policies and coding guidelines.
  • Maintains strictest confidentiality.
  • Performs other miscellaneous duties as required.



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.



Posted: 2020-08-14 Expires: 2020-10-29

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Certified Coding Specialist - Denver, CO

UnitedHealth Group
Denver, CO 80204

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