Certified Inpatient, Facility Coding Account Manager - Remote
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Jobs in this function provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
- Manages daily vendor coding production to ensure deliverables are met
- Impact of work is most often at the local level
If you are able to work in CST and EST time zones, you will have the flexibility to work remotely* as you take on some tough challenges.
- Plans, monitors, directs and evaluates coding production on a daily basis (M-F and weekend coverage as necessary); ensures that daily site coding drop schedules are met; if system issues or other emergencies delay coding, implements measures/schedules to return to established coding schedules at the earliest possible time
- Identifies day-to-day operational priorities and other workflow issues; adjusts coders, data specialists and other staff as necessary to ensure a constant flow of work so that delivery schedules are met; notifies the Director immediately if a problem arises that causes a redirection of work or inability to meet work/drop cycles; coordinates with QM personnel to balance resource needs between Coding and QM
- Tracks service level performance to ensure that coders are performing within the established quality, production, and financial performance criteria; provides feedback on revisions to performance parameters as service deliverables change
- Maintains technical knowledge of coding and ensures that understanding of policies is consistent with that of QM; ensures that all coders understand and implement new coding policies; triages routine coding questions and serves as a resource to the client; communicates educational needs and issues to QM
- Assists in the development and revision of operational policies and procedures that facilitate efficient workflow
- Develops an understanding of the workflows, procedures, and site-specific criteria for each assigned client
- Maintains a thorough understanding of all software applications used by coding operations personnel
- Mindful of the need to optimize coding department revenues and minimize operational costs
- Emphasizes productivity goals and takes action to ensure effective and efficient use of staff and own time is maintained
- Creatively plans for allocation of extra capacity for backlog coding and other revenue generating projects
- Makes suggestions for ways to reduce costs and enforces policies designed to minimize department expenses
- On an annual basis, or more frequently as needed, assesses margins for assigned sites and works with coding management and others to implement changes designed to increase efficiency and reduce costs
- Ensures that all inputs and follow-up for the invoicing process are completed accurately and in a timely manner (month-end invoicing reports, aged A/R follow-up); Proactively seeks out and resolves any potential invoicing problems
- Provides on-going client support and demonstration of Optum value to clients including:
- Prepares and sends monthly reports to communicate performance and contribution toward client goals
- Makes at least monthly phone calls to primary client representative or others as needed. Visits clients as necessary or as per contract
- Communicates any policy changes to clients and coordinates implementation of any client requested changes in the appropriate format, e.g., chargemasters, site specifics
- Assists in troubleshooting problems and ensures timely follow-up and/or resolution and communication of outcomes
- Provides benchmarking data and other service and product information to clients with a goal of ensuring that clients are aware of Optum value
- Builds long-term client relationships by understanding the client’s environment, business strategies and future needs and communicating how Optum can assist them to meet their goals
- Follows through on any client interest or inquiry for additional Optum products or services by informing the appropriate resources and assisting with implementations
- Provides support information for the contracting process for new clients and additional services for existing Optum clients
- Obtains and maintains an understanding of all Optum product lines
- Actively participates in internal meetings to discuss each client status: coding data trends/patterns/changes, physician and other provider documentation quality, and any recent issues that impact the client
- Participates with Technical Operations Manager, Product Management, IS, Coding Management, and client representatives, in initial assessment and determination of specific requirements for successful coding implementations
- Functions as an implementation team member and works closely with the client and associated Optum departments to successfully implement Optum services and products
- Informs the Director when additional resources are needed based on the established production goals and quality standards
- Enacts necessary training and orientation plans to ensure successful orientation and retention of each employee
- Visits and/or communicates regularly with remote employees. Ensures that all remote employees are performing their assigned jobs professionally
- Presents a positive image/demeanor and demonstrates a superior customer service orientation when interacting with clients
- Promotes and supports the corporation, its products/services, and its affiliates (employees, contractors, and agents) at all times
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.
- Certification: CPC, CCS, RHIA, or RHIT
- 4+ years of experience managing Coding Operations for a large multi-facility or multi-practice organization
- 2+ years of experience working with a Coding Operations Vendor Management Organization
- Bachelor’s degree
- Experience in EMR’s Epic or Cerner
- Client facing presentation experience
- Ability to answer complex coding questions from clients (SME)
Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
Connecticut or New York City Residents Only: The salary range for Connecticut or New York City residents is $67,800 to $133,100. 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.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves 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.
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.