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Certified Coding Consultant - Franklin, TN

UnitedHealth Group


Location:
Franklin, TN
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1778650
Apply on the Company Site
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Job Details


Certified Coding Consultant - Franklin, TN(Job Number:727513)
Description

Position Description:


Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.
 
Positions in this function are responsible for investigating, reviewing, and resolving Professional and / or Facility provider claims on behalf of our commercial and government customers and their health plans. This may include leading as an expert in telephone calls or meetings with providers, clients and other investigative areas. A critical function of this role is ensuring adherence to state and federal compliance policies, reimbursement policies and contract compliance.
 
The Certified Coding Consultant will investigate, review, and provides clinical and / or coding expertise in the application of medical and reimbursement policies within the claim adjudication process through file review.  This could include Medical Director / Physician consultations, interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies and consideration of relevant clinical information.
 
Primary Responsibilities:
  • Perform CPT coding / DRG validations and provide outcomes management for decreasing denied claims.
  • Will compose educational letters to provide information on coding guidelines and regulations support the medical record findings. 
  • Assist educators with their coding questions.
  • Required to complete 12 - 15 DRG validations /or 6-8 coding audits per week and provide educational letters on those reviews back to providers.
  • Conduct chart audits to assure claims are paid accurately and contributes to the overall recoveries

Job Claim Recovery/Resol/COB/Subro
Primary Location US-TN-Franklin
Other Location 
Organization Optum Ops-Payment Integrity
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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