Ambulatory SME/Educator - Remote
Company: UnitedHealth Group
Location: San Diego
Posted on: June 25, 2022
Job Description:
You'll enjoy the flexibility to telecommute* from anywhere
within the U.S. as you take on some tough challenges. Healthcare
isn't just changing. It's growing more complex every day. ICD - 10
Coding replaces ICD - 9. Affordable Care adds new challenges and
financial constraints. Where does it all lead? Hospitals and
Healthcare organizations continue to adapt, and we are vital part
of their evolution. And that's what fueled these exciting new
opportunities. Who are we? 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 Healthcare 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 Employees are required
to have flexibility to work any of our 8-hour shift schedules
during our normal business hours of 8:00am - 5:00pm. It may be
necessary, given the business need, to work occasional overtime.
*All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy. Primary Responsibilities:
- Assesses and interprets needs of the Ambulatory Coding Team by
prioritizing work to meet deadlines.
- Identifies solutions to non-standard edits, workflows, and
issues.
- Solves complex questions and conducts analysis of trends to
provide education for the coding staff and clients including
physicians/providers.
- Provides detailed education to the Coding Team and acts as a
resource to others. -
- Train and review assignments completed by new employees and
provide post-hire reviews as needed.
- Apply expert coding knowledge to professional coding and
billing initiatives and inquiries.
- Identify appropriate assignment of ICD-10-CM, CPT, and HCPCS II
Codes for physician services, while adhering to the official coding
guidelines and established client coding guidelines of the assigned
facility
- Understand the Medicare Ambulatory Payment Classification (APC)
codes
- Adhere to the ethical standards of coding as established by
AAPC and/or AHIMA
- Adhere to and maintain required levels of performance in both
coding quality and productivity as established by Optum360
- Understand federal coding register and ensure guidelines are
used and followed appropriately. -
- Understanding of appeal process with knowledge how to speak to
denial and/or appeals.
- Provide documentation feedback to providers and query
physicians when appropriate
- Maintain up-to-date Coding knowledge by reviewing materials
disseminated/recommended by the Compliance, Coding Operations,
etc.
- Participate in coding department meetings and educational
events
- Strong knowledge of coding clinics and how to obtain education
information.
- Process Rebills as appropriate.
- Other duties at the discretion of the Coding Supervisor You'll
be rewarded and recognized for your performance in an environment
that will challenge you and give you clear direction on what it
takes to succeed in your role as well as provide development for
other roles you may be interested in. Required Qualifications:
- High School Diploma / -GED (or higher)
- Professional coder certification with credentialing from AHIMA
and/or AAPC (CPC, CCS-P, RHIA, RHIT) to be maintained annually
- 3+ years of Physician medical coding (ICD-10, CPT, HCPCS II)
experience in a multi-specialty physician clinic
- Intermediate knowledge of OCE, MUE and NCCI classification and
reimbursement structures
- Expert level experience working in a level I trauma center
and/or teaching hospital with a mastery of complex procedures in
one or more the following specialty areas: Cardiothoracic, Vascular
and Cardiac Catheterizations, Orthopedics, Neurology, Neurosurgery,
General Surgery, OB/GYN, Hospitalist, and other specialties -
- Experience in Inpatient/Observation E/M coding
- Ability to use a PC in a Windows environment, including
Microsoft Excel and various EMR systems
- Ability to provide expert level coding guidance to physicians,
practitioners, and coders as needed
- Full COVID-19 vaccination is an essential job function of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements. UnitedHealth
Group will adhere to all -federal, state -and local regulations as
well as all client requirements and will obtain necessary proof of
vaccination, and boosters when applicable, prior to -employment to
ensure compliance. -Candidates must be able to -perform all
essential job functions with or without reasonable accommodation. -
Telecommuting Requirements:
- Required to have a dedicated work area established that is
separated from other living areas and provides information
privacy
- Ability to keep all company sensitive documents secure (if
applicable)
- Must live in a location that can receive a UnitedHealth Group
approved high-speed internet connection or leverage an existing
high-speed internet service Preferred Qualifications:
- Experience auditing charts in a professional coding
environment
- Experience providing physician/coding education -
- Experience with various systems
- Intermediate level of experience with Microsoft Excel (create,
edit, search, format spreadsheets) Soft Skills:
- Ability to communicate effectively face-to-face and in writing
UnitedHealth Group requires all new hires and employees to report
their COVID-19 vaccination status. Military & Veterans find your
next mission: We know your background and experience is different
and we like that. UnitedHealth Group values the skills, experience
and dedication that serving in the military demands. In fact, many
of the values defined in the service mirror what the UnitedHealth
Group culture holds true: Integrity, Compassion, Relationships,
Innovation and Performance. Whether you are looking to transition
from active duty to a civilian career, or are an experienced
veteran or spouse, we want to help guide your career journey. Learn
more at Learn how Teresa, a Senior Quality Analyst, -works with
-military veterans and ensures they receive the best benefits and
experience possible. - Careers with Optum360. At Optum360, we're on
the forefront of health care innovation. With health care costs and
compliance pressures increasing every day, our employees are
committed to making the financial side more efficient, transferable
and sustainable for everyone. We're part of the Optum and
UnitedHealth Group family of companies, making us part of a global
effort to improve lives through better health care. In other words,
it's a great time to be part of the Optum360 team. Take a closer
look now and discover why a career here could be the start to doing
your life's best work.SM Colorado, Connecticut or Nevada Residents
Only: The salary range for Colorado residents is $25.63 - $45.72.
The salary range for Connecticut / Nevada residents is $28.27 -
$50.29. Pay is based on several factors including but not limited
to education, work experience, certifications, etc. In addition to
your salary, UnitedHealth Group offers benefits such as, a
comprehensive benefits package, incentive and recognition programs,
equity stock purchase and 401k contribution (all benefits are
subject to eligibility requirements). No matter where or when you
begin a career with UnitedHealth Group, you'll find a far-reaching
choice of benefits and incentives Diversity creates a healthier
atmosphere: UnitedHealth Group is an Equal Employment Opportunity /
Affirmative Action employer and all qualified applicants will
receive consideration for employment without regard to race, color,
religion, sex, age, national origin, protected veteran status,
disability status, sexual orientation, gender identity or
expression, marital status, genetic information, or any other
characteristic protected by law. UnitedHealth Group is a drug -
free workplace. Candidates are required to pass a drug test before
beginning employment. Keywords: -#RPO, #Yellow
Keywords: UnitedHealth Group, San Diego , Ambulatory SME/Educator - Remote, Other , San Diego, California
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