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Coding Manager - Bakersfield, CA

UnitedHealth Group

Bakersfield, CA
Job Code:
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Job Details

Coding Manager - Bakersfield, CA(Job Number:723342)

Who are we?  Optum360.  We’re a dynamic partnership formed by Dignity Health and Optum to combine our unique expertise.  As part of the growing family of UnitedHealth Group, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity
and a full suite of revenue management services to health care providers nationwide.  
If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be.  It’s an opportunity to do your life’s best work.(sm)


Coding Manager is a regional position, responsible for the daily operations including planning, organizing, staffing, directing, and controlling all functions of the Coding, programs. Coding Manager will manage, oversee, and monitor the process for the coding operations, and direct, support, and educate the staff, interact with Compliance, QA,  and other professional and support staff to ensure quality and consistency of ICD-10, CPT, and documentation guidelines according to CMS regulations and the organization's Compliance Plan.


This position will be Monday-Friday daytime hours, working onsite at both Mercy and Memorial Hospitals in Bakersfield, CA


Primary Responsibilities: 

  • Responsible for the day to day department administrative operations, monitoring that DNFB is at 1 day after suspense period 
  • Assigns accounts to coders as needed (high dollar, oldest) in order to maintain DNFB using available reports for distribution of accounts
  • Oversight of coding functions associated with CMS billing guidelines
  • Works closely with CDI staff to incorporate query processes into best coding practices
  • Ensure coding quality in regards to CPT, ICD-10 CM and PCS methodology, ensuring optimal quality and reimbursement within Federal and State regulations
  • Establish policies and implement changes
  • Coordination with other HIM operations managers, leads, and coordinators
  • Review departmental procedures and evaluate the effectiveness of personnel
  • Analyze denial and rejection reports and appeals whenever appropriate
  • Proactively provide information, direction, and updates relevant to coding to providers
  • Review patient medical records to assign codes for diagnoses, treatments, surgical procedures, and nonsurgical procedures for hospital services
  • Maintains a working knowledge of CPT and ICD-10 coding principles, governmental regulations, protocols and third-party requirements pertaining to billing and documentation
  • Ensures all services documented in the patient’s chart are coded with appropriate diagnoses and procedure codes. When services are not documented appropriately, seeks to attain proper documentation in a timely manner.  Works with Revenue Integrity (Charging) and ancillary departments as needed for correct claim components
  • Reviews records to ensure compliance with coding and documentation guidelines and governmental requirements.   Escalates issues to Audit area as needed for further review
  • Conducts education to physicians as needed in order to clarify documentation requirements
  • Ensures maximum efficiency and reimbursement for properly documented services
  • Performs other related duties as assigned or requested in a professional manner

Job Clinical Admin & Processing
Primary Location US-CA-Bakersfield
Other Location United States
Organization O360 Dignity Health Middle Ops
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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