Clinical Quality Coding Analyst - Hackensack, NJ - Full-time / Part-time

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
 
The Clinical Quality Coding Analyst (CQCA) demonstrates experience by correlating coding accuracy with correct HCC assignment.  The CQCA is responsible for conducting the audit to improve and increase members annual funding in order to drive better patient care and assist providers through education and training to improve RAF score accuracy.
 
The CQCA will comply with Coding and Corporate Compliance standards. Abides by ethical standards and adheres to official coding guidelines. The individual in this role will perform the crucial task of assuring accuracy of codes from the listing of International Classification of Diseases, Tenth Revision; (ICD-10-CM).
 
Primary Responsibilities:

Contact physicians, medical groups, IPAs and hospitals who would benefit from Medical Risk Adjustment training, and build positive, consultative relationships
Educate providers on how to improve their Risk Adjustment Factor (RAF) scores, which measure their patients' health status
Training providers on Risk Adjustment methods and tools, coding compliance, documentation guidelines, HCC education and Medicare/Medicaid regulations by proactively providing solutions to meet the needs of the client providers
Implement education, and provide formal training to client providers and staff as needed regarding Collaborating with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment education efforts
Schedule physician chart audits (including research and presentation) and provide patient lists to practice managers to promote a smooth audit process
Assess and interpret whether the coding assigned by the provider was properly assigned based upon review of the medical documentation and application of the coding guidelines
Assist other team members in coding, HCC opportunities and act as a resource to less experienced staff
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10 CM knowledge
Provide feedback and present solutions, to the Associate Director of Clinical Coding and Quality, regarding trends or patterns noticed in provider coding
Excellent communication and presentation skills and ability to demonstrate a professional image wearing business attire
Excellent understanding of medical terminology, disease process and anatomy and physiology

Required Qualifications:

3 + years of coding experience, including ICD-10
Must have completed coding certification course, AAPC/AHIMA, or other accredited certifying body, or completed college courses with degree in coding or currently enrolled in program
Must possess a CPC, COC, CRC, CIMC, CFPC, CPMA, CCS, CCA, CDIP, or RHIT certification or obtain within 90 days of employment
Excellent computer skills (i.e. MS Office)
Ability to travel locally 75% of work week to Provider offices
A valid Driver’s license
Preferred Qualifications:

Supervisory experience a plus
Knowledge of Risk Adjustment HCCs a plus
Previous consulting or sales experience a plus
Excellent computer skills (i.e. MS Office)
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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: 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: Analyst, Certified Professional Coder (CPC), New York, NY