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Risk Adjustment Medical Coding Analyst - Winter Park, FL

UnitedHealth Group


Location:
Orlando, FL
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1771923
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Job Details


Risk Adjustment Medical Coding Analyst - Winter Park, FL(Job Number:724732)
Description

Health care isn't just changing. It's growing more complex every day. Because of this hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. 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)
 
Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member-centric approach to care. As an Inpatient Medical Coder you will determine and record the correct medical codes for all treatments and health services. Ensuring proper records is just one way your work will impact the health and wellness of our members on a huge scale.

Who are we? We're Optum360. We're a dynamic new 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.

The Medical Coding Analyst validates progress notes and enters the appropriate ICD-9/ICD-10 coding into the DataRAP® database utilizing the Centers for Medicare and Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) guidelines.  This position is also responsible for timely communication of identified quality issues concerning documentation and validation pertaining to the CMS-HCC methodology and ICD-9/ICD-10 CM coding guidelines back to the provider.
 
Primary Responsibilities:
  • Processes attestation sheets and progress notes out of the RightFax work queue according to DataRAP® department guidelines
  • Analyzes progress notes and documentation sent by providers for validation following CMS guidelines and ICD-9 / ICD-10 Coding Manual guidelines and enters final results into appropriate tab of the DataRAP® database
  • Performs the minimum number of validations consistent with established departmental goals
  • Provides clear communication, with use of DataRAP® application, through query to PCP on documentation not meeting standard as identified by “no plan”
  • Provides clear communication, with use of DataRAP® application, through query to PCP on documentation not meeting standard of basic administrative components to a progress note
  • Ensures accuracy of entry by comparing to outcome of diagnoses on eAttestation post validation entry
  • Associates attestation sheets received into the DataRAP® database to provide tracking for all markets
  • Identifies and reports quality concerns and errors to DataRAP® Clinical Process Quality Analyst for review and education
  • Responsible for providing coding support to the DataRAP® Clinical Coding Nurses and to the providers participating in the DataRAP® process
  • Performs all other related duties as assigned

Job Medical Coding
Primary Location US-FL-Orlando
Other Location 
Organization WellMed Medical Mgmt, Inc
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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