4 days old

Sr. Risk Adjustment Coder - Telecommute

West Valley City, UT 84119 Work Remotely
  • Job Code

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

The Sr. Risk Adjustment Coder will provide Hierarchical Condition Category (HCC) coding services for outpatient and inpatient charts. This includes the analysis and translation of medical diagnoses with the ultimate goal of improvement in coding accuracy across the network. This position will evaluate clinical coding from medical records to ensure accurate coding of encounter data and recommends processes to ensure accurate and efficient coding practices. They will also assist in providing feedback regarding coding and reimbursement, participate in operational activities and work with network managers, medical director, market leader, stakeholders and other employees to ensure improvement in coding accuracy. The Sr. Risk Adjustment Coder will maintain high level (96%) coding accuracy and complete work within assigned queue in established timeframe.


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


Primary Responsibilities:

  • Support the OptumCare Utah Care Delivery Organization (CDO) and Mountain West Region (MWR) Coding Team
  • Process physician attestation forms and PCP visits at a minimum of 6 charts per hour
  • Perform inpatient chart reviews for Medical Management (MM)
  • Build and sustain effective relationships while working closely with manager, coding supervisor, coding team, Mountain West Region, Enterprise Clinical Performance, coding educators and network managers
  • 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 
  • Identifies suspect/unreported HCC codes in the notes/records to reflect the severity of the patient's condition.
  • Performs level one 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.
  • Maintains a 96% quality audit accuracy rate.
  • Attend internal meetings via WebEx as requested
  • Additional projects as assigned

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: 2020-10-15 Expires: 2020-11-14

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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Sr. Risk Adjustment Coder - Telecommute

UnitedHealth Group
West Valley City, UT 84119

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