Facility Outpatient Coder / Reimbursement Specialist - Telecommute Considered

No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. You'll help improve the health of millions. And you'll do your life's best work.(sm)
 
Primary Responsibilities:

Function as an Outpatient Prospective Payment System (OPPS) coding, billing, reimbursement, and regulatory policy subject matter expert (SME) for Optum360 Coding Solutions
Apply expertise in current coding systems (ICD - 9 - CM / ICD - 10 - CM / CPT / HCPCS), OPPS and Ambulatory Surgery Center (ASC) reimbursement methodologies, and operational expertise to provide up - to - date, clear and concise content for all products
Apply basic knowledge of other payment systems for example, Inpatient Prospective Payment System (IPPS) End Stage Renal Disease (ESRD), Home Health and Skilled Nursing
Apply working knowledge of the 837i and UB-04 claim forms
Maintain official sources that are a defensible source of information to support product content
Respond to ICD - 9 - CM / ICD - 10 - CM / CPT / HCPCS and Medicare questions / queries for internal and external customers
Suggest new product ideation and product enhancements in a timely manner that reflects customer needs and industry standards
Provide New Product SME, Clinical Technical Editor (CTE) team members, Product Managers, Sales and Marketing with information on healthcare industry changes that impact our business
Deliver high quality content, on time and within budget. Responsible for working within project guidelines also known as scope of work (SOW), leading projects or working collaboratively as a Tech 1 or 2, and meeting schedule deadlines (standard 100%) while maintaining the accuracy and integrity of the content (accuracy standard 97%)
Demonstrate ability to perform work in a team environment, both as a peer in a Tech 1 & Tech 2 partnership and as a lead CTE as necessary
Demonstrate the ability to multitask and toggle between multiple projects
Keep pace with market standards by keeping abreast of regulatory changes, official coding guidelines, and by developing and maintaining relationships with customers and industry experts within and outside of Optum360
Responsible for conducting research to support the creation of new products or product updates by using various avenues such as hard copy reference material (internal & external publications), internet searches inclusive of CMS website, other official websites, list serves, databases, seminar / conference material, interviews, and interactions with customers
Update both the scope of work and product spec document for each update throughout the year prior to the kickoff meeting i.e., specifically list all components of the product under component checklist inclusive of each individual attachment, describe in detail update requirements under scope of work, list the official resources to be used, review and update the product spec section of the document. If product specs are not included in the SOW template they must be added prior to the product going to Print Services
Communicate schedule changes and content concerns to the Director and Product Manager
Responsible to contribute new product ideas
Enhance the visibility of Optum360 by conducting presentations or functioning as an expert in panel discussions at professional conferences / seminars at a national, state or local level, by functioning as a contributing editor for professional journals, or by functioning as an advisory board member
Responsible for assisting in the development of Coding Solutions CTE goals and measurable business objectives
Meet or exceed all MBOs, accuracy and TAT standards
Relationships:

Report to the Director or Manager of Clinical Technical Editors in Coding Solutions
Interface with New Product SME, Sr. Director of Editorial Services, Schedule Coordinator, Product Management, DBAs, Optum Consultants, Solutions & Technology clinical teams, Customer Service, Sales & Marketing, and external customers
Work in collaboration with Product Managers to ensure the Coding Solutions team has a thorough knowledge of the subject matter and market, as well as the regulatory environment
Collaborate with CTE team members, Product Managers, and Coding Solutions team to ensure product plans are in line with customer needs as well as corporate goals & strategies, and to grow product lines
Discuss and promote new product ideas with New Product SME, Product Managers and provide input as needed i.e. product design / presentation
Work closely with both internal and external customers to deliver the highest level of customer service. The standard for turnaround time (TAT) is a response within one business day, subsequent responses within two business days i.e., query requires research
Work in collaboration with your CTE partner to update the scope of work (SOW) and product specs, keep product on time and on budget, and ensure the quality of the content
Work in collaboration with the editorial and desktop staff to answer questions on content, and to ensure markup meets markup standards

Required Qualifications:
 
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.