Ambulatory SME/Educator - Remote
Company: UnitedHealth Group
Posted on: June 25, 2022
You'll enjoy the flexibility to telecommute* from anywhere
within the U.S. as you take on some tough challenges.
Healthcare isn't just changing. It's growing more complex every
day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new
challenges and financial constraints. Where does it all lead?
Hospitals and Healthcare organizations continue to adapt, and we
are vital part of their evolution. And that's what fueled these
exciting new opportunities.
Who are we? Optum360. We're a dynamic new partnership formed by
Dignity Health and Optum to combine our unique expertise. As part
of the growing family of UnitedHealth Group, we'll leverage our
compassion, our talent, our resources and experience to bring
financial clarity and a full suite of Revenue Management services
to Healthcare Providers, nationwide.
If you're looking for a better place to use your passion, your
ideas and your desire to drive change, this is the place to be.
It's an opportunity to do your life's best work.SM
Employees are required to have flexibility to work any of our
8-hour shift schedules during our normal business hours of 8:00am -
5:00pm. It may be necessary, given the business need, to work
*All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy.
- Assesses and interprets needs of the Ambulatory Coding Team by
prioritizing work to meet deadlines.
- Identifies solutions to non-standard edits, workflows, and
- Solves complex questions and conducts analysis of trends to
provide education for the coding staff and clients including
- Provides detailed education to the Coding Team and acts as a
resource to others. -
- Train and review assignments completed by new employees and
provide post-hire reviews as needed.
- Apply expert coding knowledge to professional coding and
billing initiatives and inquiries.
- Identify appropriate assignment of ICD-10-CM, CPT, and HCPCS II
Codes for physician services, while adhering to the official coding
guidelines and established client coding guidelines of the assigned
- Understand the Medicare Ambulatory Payment Classification (APC)
- Adhere to the ethical standards of coding as established by
AAPC and/or AHIMA
- Adhere to and maintain required levels of performance in both
coding quality and productivity as established by Optum360
- Understand federal coding register and ensure guidelines are
used and followed appropriately. -
- Understanding of appeal process with knowledge how to speak to
denial and/or appeals.
- Provide documentation feedback to providers and query
physicians when appropriate
- Maintain up-to-date Coding knowledge by reviewing materials
disseminated/recommended by the Compliance, Coding Operations,
- Participate in coding department meetings and educational
- Strong knowledge of coding clinics and how to obtain education
- Process Rebills as appropriate.
- Other duties at the discretion of the Coding Supervisor
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.
- High School Diploma / -GED (or higher)
- Professional coder certification with credentialing from AHIMA
and/or AAPC (CPC, CCS-P, RHIA, RHIT) to be maintained
- 3+ years of Physician medical coding (ICD-10, CPT, HCPCS II)
experience in a multi-specialty physician clinic
- Intermediate knowledge of OCE, MUE and NCCI classification and
- Expert level experience working in a level I trauma center
and/or teaching hospital with a mastery of complex procedures in
one or more the following specialty areas: Cardiothoracic, Vascular
and Cardiac Catheterizations, Orthopedics, Neurology, Neurosurgery,
General Surgery, OB/GYN, Hospitalist, and other specialties
- Experience in Inpatient/Observation E/M coding
- Ability to use a PC in a Windows environment, including
Microsoft Excel and various EMR systems
- Ability to provide expert level coding guidance to physicians,
practitioners, and coders as needed
- 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.
- Required to have a dedicated work area established that is
separated from other living areas and provides information
- Ability to keep all company sensitive documents secure (if
- Must live in a location that can receive a UnitedHealth Group
approved high-speed internet connection or leverage an existing
high-speed internet service
- Experience auditing charts in a professional coding
- Experience providing physician/coding education -
- Experience with various systems
- Intermediate level of experience with Microsoft Excel (create,
edit, search, format spreadsheets)
- Ability to communicate effectively face-to-face and in
UnitedHealth Group requires all new hires and employees to report
their COVID-19 vaccination status.
Military & Veterans find your next mission: We know your background
and experience is different and we like that. UnitedHealth Group
values the skills, experience and dedication that serving in the
military demands. In fact, many of the values defined in the
service mirror what the UnitedHealth Group culture holds true:
Integrity, Compassion, Relationships, Innovation and Performance.
Whether you are looking to transition from active duty to a
civilian career, or are an experienced veteran or spouse, we want
to help guide your career journey. Learn more at
Learn how Teresa, a Senior Quality Analyst, -works with -military
veterans and ensures they receive the best benefits and experience
Careers with Optum360. At Optum360, we're on the forefront of
health care innovation. With health care costs and compliance
pressures increasing every day, our employees are committed to
making the financial side more efficient, transferable and
sustainable for everyone. We're part of the Optum and UnitedHealth
Group family of companies, making us part of a global effort to
improve lives through better health care. In other words, it's a
great time to be part of the Optum360 team. Take a closer look now
and discover why a career here could be the start to doing your
life's best work.SM
Colorado, Connecticut or Nevada Residents Only: The salary range
for Colorado residents is $25.63 - $45.72. The salary range for
Connecticut / Nevada residents is $28.27 - $50.29. 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
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.
Keywords: -#RPO, #Yellow
Keywords: UnitedHealth Group, Indianapolis , Ambulatory SME/Educator - Remote, Other , Indianapolis, Indiana
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