Coding Quality Analyst @ Optum

Primary Responsibilities:

• Identify appropriate assignment of ICD 10 CM and ICD 10 PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC / MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Abstract additional data elements during the Chart Review process when coding, as needed
• Adhere to the ethical standards of coding as established by AAPC and / or AHIMA
• Ability to code 1.5-2.5 charts per hour and meeting the standards for quality criteria
• Needs to constantly track and implement all the updates of AHA guidelines
• Provide documentation feedback to providers and query physicians when appropriate
• Maintain up to date Coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding
• Operations Managers, and Director of Coding / Quality Management, etc.
• Participate in coding department meetings and educational events
• Review and maintain a record of charts coded, held, and / or missing
• Be an ideal team player who can work in a large group and provide inputs to the team for betterment of the team in terms of quality and productivity
• Under general supervision, organizes and prioritizes all work to ensure that records are coded and edits are resolved in a timeframe that will assure compliance with regulatory and client guidelines
• Adherence with confidentiality and maintains security of systems. Compliance with HIPAA policies and procedures for confidentiality of all patient records
• Demonstrates knowledge of security of systems and associated policies and procedures for maintaining the security of the data contained within the systems
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Life Science or Allied Medicine Graduates
• Certification from AAPC or AHIMA (CIC certification preferred)
• 5+ years of Acute Care Inpatient medical coding experience (hospital, facility, etc.)
• Experience with working in a level I trauma center and / OR teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding
• ICD 10 (CM & PCS) and DRG coding experience

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.

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