National Coding Educator - 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.    

The National Coding Educator acts as a provider engagement specialist.  This is a virtual position responsible for providing expertise in the area of risk adjustment and quality coding for provider clients. A National Coding Educator will interface with operational and clinical leadership to assist in identification of operational and clinical best practices in maximizing recapture rates, understanding clinical suspects, and monitoring of appropriate clinical documentation and correct coding.  He/She will also coordinate implementation of programs designed to ensure all diagnoses are coded in accordance with CMS and risk adjustment coding guidelines and all conditions are properly supported by appropriate documentation in the patient chart.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Partners with Healthcare Advocates in the field  to consult and educate providers and their staff based on data analysis where support / training is needed to improve documentation and coding accuracy
• Supports providers in understanding CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation and diagnosis coding to ensure compliance
• Utilizes analytics and identifies and targets providers for chart review
• Utilizes analytics and identifies target providers for Medicare Advantage Risk Adjustment training and documentation and coding education
• Facilitates and performs audits of the providers' medical charts to ensure appropriate documentation that supports the diagnoses submitted
• Ensures that provider documentation supports the submission of relevant ICD-10-CM and CPT II codes, when appropriate, in accordance with national coding guidelines
• Routinely consults with medical providers to provide feedback regarding identified coding errors and omissions and deliver targeted coding education
• Ensures member encounter data (diagnoses and quality care) is being accurately documented and relevant diagnosis and quality codes are being captured
• Provides thorough, timely and accurate consultation on ICD-10-CM and/or CPT II coding by providers or practice clinical consultants
• Provides ICD-10-CM and CPT II coding training to providers and appropriate staff
• Develops and presents coding presentations and training to small and large groups of clinicians, practice managers and certified coders, customizing training to fit specific provider's needs
• Develops and delivers diagnosis coding tools and quality reporting tools to providers, coders and billers
• Trains physicians and other staff regarding documentation and coding and provides feedback to physicians regarding documentation practices
• Educates providers and staff on coding regulations and changes as it relates to Risk Adjustment and Quality Reporting to ensure compliance with state and federal regulations
• Performs analysis and provides formal feedback to providers as indicated or as requested
• Provides measurable, actionable solutions to providers that will result in improved accuracy in documentation and coding practices
• Reviews selected medical documentation to determine if diagnosis codes and quality reporting codes are appropriately assigned
• Assesses adequacy of documentation and trains Provider office staff on Provider queries to clarify documentation to ensure accurate and complete coding
• Collaborates with providers, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality Reporting education efforts
• Participates in the interview and selection process for Optum Approved Trainers
• Provides ongoing educational support for Optum Approved Trainers
• Participates in Optum tool and presentation creation and in the annual update process to ensure timely completion and delivery of materials
• Works with Optum Approved Trainers during annual tool and presentation updates
• Facilitates and presents during the Optum National Coding Forum
• Collaborates with fellow National Coding Educators on a regular basis

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:

• Certified Risk Adjustment Coder (CRC) and either Certified Professional Coder (CPC) with AAPC or CCS-P with AHIMA with the requirement to obtain the AAPC Approved Instructor credential within 6 months
• 5+ years of coding training experience training providers, coders, and billers
• 4+ years of experience in Risk Adjustment and/or HEDIS/Stars Provider education
• Experience working effectively with common office software, coding software, EMR and abstracting systems
• Advanced proficiency in MS Office (Excel [Pivot tables, excel functions], PowerPoint and Word)
• Must be willing to travel 30%-50% of the time for onsite training and education as business needs dictate
• Must be able to provide proof of a valid, unrestricted Driver's License and current Auto Insurance

Preferred Qualifications:

• Certified Professional Medical Auditor (CPMA) certification
• 4+ years of clinic or hospital experience and/or managed care experience
• Experience in management position in a provider practice
• Knowledge of EMR for recording patient visits
• Knowledge of billing/claims submission and other related processes

Soft Skills:

• Excellent oral & written communication skills
• Experience giving group presentations
• Strong business acumen and analytical skills
• Ability to deliver training materials designed to improve provider compliance
• Ability to develop long-term relationships
• Good work ethic, desire to succeed, self-starter
• Ability to use independent judgment, and to manage and impart confidential information

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.    

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.