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Certified Coding Consultant Team Lead - Franklin, TN

UnitedHealth Group


Location:
Franklin, TN
Date:
12/15/2017
2017-12-152018-01-14
Job Code:
741556
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Job Details

741556 Certified Coding Consultant Team Lead Franklin TN

Certified Coding Consultant Team Lead - Franklin, TN (741556)

Position Description

Position Description:
 
 
You dream of a great career with a great company - where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.
 
This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.
 
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation and Performance.
 
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 Team Lead 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:
  • Ability to solve complex problems and develop innovative approaches
  • Serves as a key resource and provide explanations on complex and / or critical issues
  • Sought out as an expert related to coding and clinical review
  • Anticipates customer needs and proactively develops solutions to meet them
  • Research and respond to escalated inquiries
  • Training and orientation of new employees on processes and databases
  • Maintain training materials for team functions
  • Continual assessment of training needs of seasoned employees and coordination with training team on additional needs outside of department
  • Facilitate weekly certified coder meeting to address questions and share updates
  • Develop and enhance departmental documentation (Job Aides, P&P’s, etc.)
  • Monitor turnaround time actions and assure information is shared with manager if expectations are not going to be met
  • Motivates and inspires other team members
  • Contribute ideas / suggestions for process improvements and automation
Required Qualifications:
  • High School Diploma / GED
  • RN or Certified Coder
  • 5+ years of CPT and ICD-9 Coding
  • 1+ years of ICD-10 Coding
  • 4+ years of experience within the health insurance claims industry
  • Knowledge of ICD-10 CM and Evaluation Management Coding
  • Knowledge of Diagnosis Related Groups (DRG)
  • Knowledge in Health Information Systems and Coding and Abstracting Systems
  • Knowledge and experience with Electronic Medical Records (EMR) System and the content of electronic medical records
  • Intermediate proficiency with Microsoft Office products: Microsoft Excel (pivot tables and macros), Microsoft Word (creating, editing and, saving), and Microsoft PowerPoint (creation and presentation)
  • Experience creating job policy and procedure documentation
  • Experience with database use and data manipulation 
Soft Skills:
  • Ability to develop collaborative client relationships 
  • Excellent negotiation / influence, collaboration, and listening skills
  • Excellent communication and problem-solving skills
  • Ability to quickly assimilate new ideas and concepts and them in new situations
  • Effective presentation and writing skills
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So, when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.
 
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.

Keywords: recovery, resolution, consultant, inpatient, outpatient, claims, Optum, UnitedHealth Group, United Healthcare

Job Details

  • Contest Number741556
  • Job TitleCertified Coding Consultant Team Lead - Franklin, TN
  • Job FamilyClaims
  • Business SegmentOptum Operations

Job Location Information

  • Franklin, TN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt

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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