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RN Medical Records Reviewer - Cameron County, TX

UnitedHealth Group

Harlingen, TX
Job Code:
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Job Details

RN Medical Records Reviewer - Cameron County, TX(Job Number:712201)

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)
The Medical Record Reviewer is expected to work directly with Physicians and Midlevel Providers to proactively review medical records and other clinical documentation to identify possible risk adjustment codes.  The Major focus of the Medical Record Reviewer will be to collect and review documents to support physician’s healthcare management and the company’s quality and risk adjustment initiatives.
Must be Authorized to work in the U.S.
 30-40% Travel to various medical offices as indicated by WellMed

Primary Responsibilities:
  • Review medical record documents and other clinical documentation in provider’s charts to identify possible risk adjustment codes
  • Evaluate and provide feedback to improve performance of clinic staff with Data Mining techniques
  • Manage multiple provider office reviews simultaneously and collaborate with supervisor and office administrator to ensure clarity of review and to allow feedback from the provider office
  • Track, report, and monitor submissions using quality program forms, processes, and returned request for information, as well as, Data Raps, and progress reports
  • Coordinate with supervisor to develop and present reports of medical record reviews to present to physician's office staff
  • Progress relationship with Providers office to allow on-site screening if required in order to help physician meet quality program goals and potential need for RAP initiatives in each office
  • Analyze errors in submission sent to quality department by physician office and notify supervisor for process improvement plan
  • Performs all other related duties as assigned

Job Quality Management
Primary Location US-TX-Harlingen
Other Location US-TX-MISSION, US-TX-San Benito, US-KY-Brownsville, US-TX-McAllen
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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