Job Description

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)

Job Summary

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

1. Processes attestation sheets and progress notes out of the RightFax work queue according to DataRAP department guidelines.
2. 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.
3. Performs the minimum number of validations consistent with established departmental goals.
4. Provides clear communication, with use of DataRAP application, through query to PCP on documentation not meeting standard as identified by no plan.
5. 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.
6. Ensures accuracy of entry by comparing to outcome of diagnoses on eAttestation post validation entry.
7. Associates attestation sheets received into the DataRAP database to provide tracking for all markets.
8. Identifies and reports quality concerns and errors to DataRAP Clinical Process Quality Analyst for review and education.
9. Responsible for providing coding support to the DataRAP Clinical Coding Nurses and to the providers participating in the DataRAP process.
10. 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 ability to obtain one within nine months from the American Academy of Professional Coders
* Knowledge of ICD-9/ICD-10 CM guidelines and coding.
* Proficiency with Microsoft Office applications to include Word, Excel, PowerPoint and Outlook
* 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
* Strong attention to detail
* Must have the ability to perform in a deadline driven environment
* Good communication, writing, and presentation skills
* Some traveling may be required
* You will be asked to perform this role in an office setting or other company location, however, may be required to work from home temporarily due to space limitations
* Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

* Some college
* Two to four years of medical coding experience in a clinical or managed care setting
* Experience with proprietary medical coding systems

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.

Job keywords: CPC, Coder, Fort Worth, Texas, TX, mid cities, icd 10, managed care, diagnostic coding