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553632: Medical Coding Compliance Manager - Western United States Telecommuter - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Los Angeles, CA Los Angeles, California |
About this job
553632: Medical Coding Compliance Manager - Western United States Telecommuter
Health care isn't just changing. It's growing more complex every day. ICD10 replaces ICD9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. And that's what fueled these exciting new opportunities. Optum360 is 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 all our resources to bring financial clarity and a full suite of revenue management services to health care providers nationwide. If you're looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work. (sm)
We are currently looking for an experienced Medical Coding Compliance Manager to join our dynamic Compliance team. Things are exciting at Optum as we are experiencing unprecedented growth, and looking for a telecommuter based on the West Coast; ideally located in Arizona or California, but other locations in the Pacific Time Zone will also be considered. Ideal candidates will have 5+ years of coding experience with at least 3+ years of experience in a supervisory capacity of coders in a hospital or clinic setting. The Medical Coding Compliance Manager will report to Optum360's Director of Coding Compliance, and will function as a member of the Coding Compliance department to ensure that Optum360's coding practices are compliant, efficient, accurate and consistent. Specifically, the Medical Coding Compliance Manager will:
- Perform audits/reviews on an annual basis for the purpose of assessing the accuracy of coding of claims in relation to compliance
- Follow established audit/review functions and processes
- Utilize coding software and other computer programs
- Prepare audit reports in a timely manner and provide recommendations for corrective action and a timeline
- Research, develop and present education programs and presentations to physicians, coders, management and other as assigned
- Serve as a resource for Optum360 coding personnel, hospitals, CDI specialists, and physicians
- Manage through monitoring and tracking of corporate compliance initiatives related to coding and HIM
- Develop written coding compliance articles for departmental newsletter, etc.
- Contribute ideas to the departmental work plan and participate in departmental staff meetings
- Disseminate regulatory information (primarily CMS Transmittals) to key stakeholders within Optum360 and to our clients.
Other responsibilities include:
- Presents education programs on a regular basis designed to improve the accuracy and consistency of coding by coders and physicians.
- Performs regular coding audits at assigned hospitals. Perform follow-up and focused audits as directed and as necessary.
- Provide leadership and direction to HIM Directors and staff on issues related to corporate compliance, projects and initiatives.
- Serves as a resource for coders who have questions and seek clarification.
- Ensures that coders base code assignment in a manner consistent with relevant laws, regulations and standards.
- Participate in coding compliance newsletter via writing articles related to coding compliance issues.
- Assists the organization in reviews relating to internal or external investigations.
Requirements
We are seeking candidates with the following qualifications:
- Associate's degree required; Bachelor's degree preferred.
- 5+ years of coding experience, with demonstrated subject matter expertise (SME) in the application of ICD-9-CM diagnosis coding and HCPCS/CPT procedure coding.
- Professional certification in HIM or coding through the American Health Information Management Association (AHIMA) to include RHIT, RHIA, CCS, CCS-P, CCA or similar.
- 3+ years of experience in a supervisory capacity of coders in a hospital or clinic setting.
- Experience presenting education & training programs for coders, case managers, and physicians is preferred.
- Experience conducting efficient and regular coding reviews & audits and responding to technical & substantive coding questions.
- A sincere commitment to the organization mission and tenets and the willingness to assume responsibility for the accuracy of its coding and Health Information Management practices.
- Demonstrated competence with personal computers, portable data devices, networks, and Microsoft Office.
- Ability to communicate clearly, both verbal and in writing English, including the ability to present ideas and concepts effectively across organizational levels.
- Ability to manage multiple priorities and projects simultaneously.
Optum is part of the UnitedHealth Group family of companies. At Optum, we don't just develop solutions. We create innovations that have the power to transform health care. We want to make health care work better for everyone. That mission depends on hiring the best and brightest. Our team comprises high performers, challengers, risk-takers and curious minds who have compassion for the world around them. Optum employees know that their work will impact the lives of others. Work alongside us today and discover a culture of integrity, compassion, relationships, innovation and performance. Our team enjoys conversation-changing, life-changing, world-changing opportunities throughout their careers. Join us and see what it's like to do your life's best work. (sm)
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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