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UnitedHealth Group Coding Quality Analyst - Telecommute in IN in Indianapolis, Indiana

** Telecommute with restrictions: This position will primarily work remotely, but candidates must be located within central Indiana (Indianapolis market preferred) as occasional travel to American Health Network medical practices is required. **

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

This position is responsible for prospective and retrospective review of the Electronic Health Record (EHR) to assist providers in more specific and complete documentation and coding. Through interaction with the physicians and other clinicians, this role facilitates improvement in the quality, completeness and accuracy of the medical record documentation to support severity of illness, medical necessity, risk adjustment factor and level of services rendered.

If you are located in central Indiana, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Conducts concurrent reviews of selected patient records to address clarity, completeness, consistency, and precision of clinical documentation

  • Demonstrates understanding of clinical documentation requirements to ensure that the severity of illness, risk of mortality, and services provided are accurately reflected in the record

  • Serves as a resource on appropriate clinical documentation to support the coded conditions and risk adjustment factors

  • Communicates documentation discrepancies and coding definitions to the physicians both written and verbally as needed to clarify clinical documentation in accordance to query standards and/or policies

  • Conducts 1:1 educational sessions with physicians and other healthcare team members related to specific documentation and coding requirements

  • Collaborates and educates he multi-disciplinary team, including physicians, nurse practitioners, physician assistants, executive directors, practice managers, coding/billing staff and others regarding clinical documentation and coding best practices

  • Utilizes the electronic health record effectively

  • Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints

  • Participates in quality and performance improvement activities

  • Attends meetings and participates on committees as requested

  • Reviews current literature and attends training sessions and seminars to keep informed of new developments in the field and to maintain certification

  • Performs other related duties and responsibilities as directed

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.

Required Qualifications:

  • Certified Professional Coder (CPC) or Certified Coding Specialist–Physician (CCS-P)

  • At least 2+ years of coding experience in physician-based settings, such as physician offices and group practices, or in the payer environment

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders.

Preferred Qualifications:

  • Certified Risk Adjustment Coder (CRC)

  • Knowledge of anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses

  • Expertise in reviewing and assigning accurate medical codes for diagnoses performed by physicians and other qualified healthcare providers in the office setting

  • Sound knowledge of medical coding guidelines and regulations

  • Expert in ICD-10 diagnosis coding

  • A keen understanding of the impact of diagnosis coding on risk adjustment payment models

  • Apply proper diagnosis code assignment under various risk adjustment models including HCC, CDPS, ACA-HHS and private payer models

  • Understand the use of data mining from data captured through risk adjustment coding

  • Understand predictive modeling from data captured through risk adjustment coding

  • Ability to identify and communicate documentation deficiencies to providers to improve documentation for accurate risk adjustment coding

  • Expert knowledge in health information documentation, data integrity, and quality

  • Ability to apply trumping to the risk adjustment hierarchy

  • Excellent interpersonal, verbal and written communication skills

  • Strong analytical, problem-solving and organizational skills

  • Ability to work independently and as a collaborative team member

  • Strong work ethic and commitment to the Mission and Core Values of AHN

  • Proficient in desktop applications, e.g., Microsoft Office (Word and Excel)

  • Ability to operate motor vehicle with unrestricted driver’s license and insurance

The hourly range for Colorado residents is $20.77 to $36.88. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

Opportunities with American Health Network, part of Optum. When you join American Health Network (AHN), you become part of a team that strives to identify and retain the top healthcare professionals in the markets it serves. At American Health Network, we want to be the best health care organization we can be. Our mission is to improve the health of our patients. We’re a physician-led organization, operating over 70 medical offices in Indiana and Ohio, with over 300 providers and 1200 employees. We’re also part of Optum, in the UnitedHealth Group family of businesses, and 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. That’s an important differentiator as more people need our help simplifying the complexities of the American health care system. At the same time, the culture of AHN supports work-life flexibility for employees and places a high value on their physical, emotional, financial and other aspects of well-being. Find out what it means to be part of an exceptional company that values its employees, its role in health care, and making a difference one patient at a time. Take a look at American Health Network and explore a new path to 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: Coding quality analyst, medical coding analyst, certified professional coder, certified coding specialist, certified risk adjustment coder, Indianapolis

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