OPTUM Care

OPTUM Care.

  • California


  • Training.

  • Full-time.

OVERVIEW OF THE POSITION:

Responsible for taking part in the execution of the company’s Coding Proficiency program. Carries out medical chart audits for Evaluation and Management and ICD-10 coding and paperwork. User interfaces and distributes audit outcomes to clinicians and management.

ESSENTIAL FUNCTIONS:

  • Performs medical chart audits conference minimum performance requirements.
  • Educates clinicians on particular coding problems discovered in senior HMO pre-audits.
  • Submits and acts on query types to clinicians based upon “presumed” chart audit information.
  • Submits weekly audit totals to Coding management.
  • Performs claims analysis for suitable CPT and ICD-10 coding.
  • Identifies CPT unbundling in claim submissions.
  • Uses coding understanding to work the claim system modifies.
  • Performs Coding analysis of claims rejections.
  • Reviews TES edits for coding analysis.
  • Works with Claims management and IPA/ contracted clinicians on claim edit resolution.
  • Stays abreast of market coding and compliance concerns.
  • Participates in coding/ auditing conversations to make sure finest practice efforts and procedures are carried out guaranteeing optimum repayment through suitable coding.
  • Attends Coding program month-to-month conferences.
  • Uses, secures, and reveals Optum clients’ secured health details (PHI) just in accordance with Health Insurance Portability and Accountability Act (HIPAA) requirements.
  • Performs extra responsibilities as designated.

EDUCATION:

  • One or 2 years of post-high school education or a degree from a two-year college.
  • Coding accreditation through AAPC or AHIMA needed.

EXPERIENCE:

Minimum:

  • Over 1 year and as much as 3 years of experience of ICD9, CPT and HCPCS coding experience or effective conclusion of Coding Program internship.

Preferred:

  • 3 years medical billing or healthcare experience.
  • IDX BAR experience.
  • Allscripts/ Enterprise experience.
  • Clinical experience.

KNOWLEDGE, SKILLS, ABILITIES:

  • Computer literate with medical billing software application.
  • Proficient in Word, Excel, PowerPoint, Multi-media projector.
  • Knowledge of CMS coding standards.
  • Excellent spoken and written interaction abilities in the English language.
  • Must have the ability to work individually to perform work efforts.
  • Bilingual/ Spanish chosen.
  • You will be asked to perform this function in a workplace setting or other business place, nevertheless, might be needed to work from house briefly due to area restrictions.

UnitedHealth Group needs all brand-new hires and workers to report their COVID-19 vaccination status.

Careers with Optum. Here’s the concept. We constructed a whole company around one giant goal; make healthcare work much better for everybody. Optum, part of the UnitedHealth Group household of services, combines a few of the best minds and many sophisticated concepts on where healthcare needs to go in order to reach its max capacity. For you, that indicates dealing with high efficiency groups versus advanced obstacles that matter. Here you’ll discover amazing concepts in one unbelievable business and a particular chance to do your life’s finest work. (SM)

Diversity develops a much healthier environment: Optum and its associated medical practices are Equal Employment Opportunity/Affirmative Action companies and all certified candidates will get factor to consider for work without regard to race, color, religious beliefs, sex, age, nationwide origin, safeguarded experienced status, impairment status, sexual preference, gender identity or expression, marital status, hereditary details, or any other particular safeguarded by law. Optum and its associated medical practices is a drug-free office. Prospects are needed to pass a drug test prior to starting work.

OPTUM Care.

  • Apply Now.