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Senior Coding Specialist - Risk Adjustment Office Based- Irvine, CA

UnitedHealth Group

Irvine, CA
Job Code:
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Senior Coding Specialist - Risk Adjustment Office Based- Irvine, CA(Job Number:708689)

We’re Monarch HealthCare, Orange County’s largest association of independent physicians, and a part of Optum and the growing family of UnitedHealth Group companies. We are changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. With the talent, resources and can - do culture of a Fortune 6 company behind us, there’s no telling how far we can go. Join us in creating a better future and you’ll soon find you’re doing your life’s best work.(sm)
Risk Adjustment Coding Education Specialist:
Summary: Responsible for risk adjustment coding team operations including physician coding and documentation education, diagnostic attestation processing, chart reviews, and development of tools to assist in PCP and / or Specialist coding success.  Review patient records for accurate and compliant coding and documentation to support appropriate reimbursement based on the HCC model. The Coding Educator Specialist is expected to work directly with Physicians and Midlevel Providers to proactively review medical records for compliant documentation and other clinical documentation to identify possible risk adjusted codes.
Primary Responsibilities:
  • Reviews and analyzes patient medical records in providers’ offices or remotely.   Ensures the records have been appropriately ICD - 10 coded to the highest level of specificity
  • Assists in the processing of attestations from providers to review for compliant and accurate documentation of current HCC conditions
  • Educates physicians, office staff, billers on CMS - HCC risk adjustment model, CDPS risk adjustment model, ACO risk adjustment model and how to utilize available reports and tools, and other related projects and initiatives
  • Responsible for administrative duties related to planning, scheduling, and conducting coding audits with physicians
  • Assists internal and external departments with billing and coding questions as well as risk adjustment related questions

Job Medical Coding
Primary Location US-CA-Irvine
Other Location US-CA-Garden Grove, US-CA-LA PALMA, US-CA-Santa Ana, US-CA-Huntington Beach
Organization Monarch
Schedule Full-time
Number of Openings 2
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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