Clinical Quality Coder - Las Vegas, NV - Full-time / Part-time

There's energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new career path? Start doing your life's best work.(sm)

Southwest Medical Associates (SMA) is a multi-specialty group of physicians, Nurse Practitioners and Physician Assistants, consisting of over 200 providers, fourteen clinical locations including nine health care centers, five urgent care clinical and an outpatient surgery center. SMA offers patients compassion, innovation, and quality care throughout southern Nevada. SMA is headquartered in the greater Las Vegas, NV area.

The Clinical Quality Coder will conduct medical record reviews on Medicare members to validate that the ICD-9 codes for HCC (Hierarchical Conditional Categories) reporting are supported by correct medical record documentation before Medicare submission.

HE/SHE will also evaluate clinical coding from medical records to ensure accurate coding of encounter data and recommends processes to ensure accurate and efficient coding practices.  Assists in providing feedback regarding coding and reimbursement.   Participate in operational activities.

Responsibilities:

• Remotely, review progress notes in EMR on Medicare members for (Medicare Risk Adjustment Payment System) to validate that the ICD-9 codes for the HCC (Hierarchical Conditional Categories) codes reported by the provider, are correct
  
• Ensure ICD-9 codes are supported by correct provider documentation before Medicare submission
  
• Identify any unsupported documentation in the progress notes and query the provider as necessary
  
• Data enter codes and query information into coding data base
  
• Ability to communicate appropriately to providers in writing and verbally, if required.  Ability to work autonomously while achieving recommended productivity rate
  
• Ability to work Monday - Friday between 6 am - 6 pm PT

Required Qualifications:

• High School diploma or equivalent
  
• Successful completion of one of the following coding certificate programs RHIA, RHIT, CCS, CCS-P, or CPC-H status
  
• Excellent organization and problem-solving skills
  
• Strong oral and written communication skills
  
• Ability to use independent judgment and to manage and impart confidential information
  
• Skilled in MS Word, Outlook and Excel
  
• Minimum productivity of 7-8 encounters per hour with 95% accuracy rate

Preferred Qualifications:

• Associate's degree in related field and/or equivalent and relevant work experience
  
• Reimbursement and health information technology

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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, 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.