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Risk Adjustment Clinical Documentation Improvement Specialist - Bronx/Manhattan

UnitedHealth Group

New York, NY
Job Code:
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Job Details

Risk Adjustment Clinical Documentation Improvement Specialist - Bronx/Manhattan(Job Number:689326)

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

This role will provide coding quality auditing services and evaluates clinical documentation to ensure accurate coding.  This position is also responsible for timely communication of identified quality issues concerning documentation and coding. The ultimate goal is improvement in coding accuracy across the Care Delivery.  The minimum productivity goal is set by project with an expectation of minimum 95% accuracy rate.


***This position will be traveling to 2 boroughs - Bronx and Manhattan.  Office is based at W 34th Street in Manhattan and traveling to skilled nursing facilities in both Manhattan and Bronx.***


Primary Responsibilities:

  • Assist with execution of  Internal Risk Adjustment Coding Review programs
  • Performs quality audits on vendor charts as well as Care Delivery coding teams as needed
  • Provides support and assists Care Delivery with various coding initiatives as needed
  • Ensure that Optum Coding Guidelines are consistently applied in all processes
  • Identifies issues and trends in coding and documentation that affect provider risk adjustment factor scores
  • Provides input and valuable feedback on audit results
  • Provide ICD10 - CM coding training, as it relates to HCC coding, as requested
  • Develops relationships with Care Delivery and communicates guidelines and requirements of Risk Adjustment Payment System to ensure correct coding and documentation 
  • Cross - functional collaboration with multiple teams and functions


Job Quality Management
Primary Location US-NY-New York
Other Location 
Organization Local Care Delivery Shared Svc
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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