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Senior Clinical Quality Coding Analyst - Las Vegas, NV - Full-time / Part-time
| Hours | Full-time, Part-time |
|---|---|
| Location | Las Vegas, NV Las Vegas, Nevada |
About this job
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 Senior Clinical Quality Coder evaluates clinical coding from medical records to ensure correct coding and documentation of encounter data and recommends processes for accurate coding practices. Develops relationships with providers and communicates guidelines and requirements of RAPS program to ensure correct coding and documentation. HE/SHE will also identify issues and trends in coding and documentation that affect provider risk adjustment factor scores.
***This position requires you to reside in Las Vegas, NV, This is part time work from home and part time traveling locally to provide Physician education!***
Primary Responsibilities:
- Performs medical record review of charts comparing ICD-9 codes for Medicare submission to provider documentation.
- Identify any discrepancies between the submitted ICD-9 codes and the medical records
- Completes audit summary worksheet and includes all discrepancies and results with feedback for educational purposes
- Function as a member of a self-directed team to meet specific individual metrics. Ability to communicate in writing and verbally
- Ensure consistent application of the audit criteria
- Document audit results, findings, actions, and outcomes in accordance with ICD-9 and Medicare Risk Adjustment Payment System guidelines
- Develops relationships with providers and communicates guidelines and requirements of Risk Adjustment Payment System to ensure correct coding and documentation
- Identifies issues and trends in coding and documentation that affect provider risk adjustment factor score
- Assists in delivering additional coding education as needed
Requirements
Required Qualifications:
- High School diploma or GED
- Successful completion of coding certificate/credential program, RHIA, RHIT, CCS, CCS-P, or CPC status
- 7+ years experience in ICD-9 coding reimbursement and health information technology (inpatient hospital coding experience preferred).
- Successfully complete SMA coding test upon onsite interview
- Skilled in MS Word
- Must have reliable transportation, proof of insurance and valid Nevada driver's license
- Must be willing to travel locally to physician's offices to conduct physician education
Preferred Qualifications:
- Bachelor's degree in related field
- Hospital and HCC (Hierarchical Conditional Categories) coding experience
- Previous experience in provider education
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.
Job Keywords: RHIA, RHIT, CCS, CCS-P, or CPC-H, Coding, ICD-9, Southwest Medical Associates, SMA, Las Vegas, Nevada, NV, UnitedHealth Group, UHG
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