Medical Coder – San Antonio, TX

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. 

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.

Essential Job Functions:

• 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
• 1+ years of working knowledge of ICD-9/ICD-10 CM guidelines and coding.
• Intermediate 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.

Preferred Qualifications:

• Associate’s Degree or higher
• 2+ years of medical coding experience with strong attention to detail and a high level of accuracy in a clinical or managed care setting.
• Experience with proprietary medical coding systems.
• Soft Skills:
• Must be able to maintain professionalism and a positive service attitude at all times.
• Ability to analyze facts and exercise sound judgment when arriving at conclusions.
• Ability to effectively report deficiencies with a recommended solution in oral and/or written form

Physical & Mental Requirements:

• Ability to lift up to 25 pounds
• Ability to sit for extended periods of time
• Ability to use fine motor skills to operate equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving

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.

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