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Job Details


UnitedHealth Group

Medical Coding Analyst - San Antonio,TX

Healthcare

Medical Director

Yearly

No

San Antonio, Texas, United States

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

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

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 or GED equivalent
  • CPC certification or proof that certification has been obtained within nine months of hire date from the American Academy of Professional Coders
  • Demonstrated knowledge of ICD-9/ICD-10 CM guidelines and coding
  • Ability to effectively report deficiencies with a recommended solution in oral and/or written form
  • Ability to analyze facts and exercise sound judgment when arriving at conclusions
  • Proven solid attention to detail
  • Ability to perform in a deadline driven environment
  • Ability to maintain professionalism and a positive service attitude at all times
  • Proficiency with Microsoft Office applications to include Word, Excel, PowerPoint and Outlook
  • Ability and willingness to travel (locally and non-locally) as determined by business need
  • 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

Preferred Qualifications:

  • Some college experience
  • 2+ years of medical coding experience with solid attention to detail and a high level of accuracy in a clinical or managed care setting
  • Proprietary medical coding systems experience

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

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.

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