POSITION DESCRIPTION

Health care isn't just changing. It's growing more complex every day. Because of this hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. If you're looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It's an opportunity to do YOUR LIFE'S BEST WORK.(SM) The MEDICAL CODING ANALYST validates progress notes and enters the appropriate ICD-9/ICD-10 coding into the DataRAP® database utilizing the Centers for Medicare and Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) guidelines. This position is also responsible for timely communication of identified quality issues concerning documentation and validation pertaining to the CMS-HCC methodology and ICD-9 / ICD-10 CM coding guidelines back to the provider.

PLEASE NOTE: THIS POSITION IS OFFICE-BASED. IT IS NOT A TELECOMMUTE ROLE.

PRIMARY RESPONSIBILITIES:

• Processes attestation sheets and progress notes out of the RightFax work queue according to DataRAP® department guidelines
• Analyzes progress notes and documentation sent by providers for validation following CMS guidelines and ICD-9 / ICD-10 Coding Manual guidelines and enters final results into appropriate tab of the DataRAP® database
• Performs the minimum number of validations consistent with established departmental goals
• Provides clear communication, with use of DataRAP® application, through query to PCP on documentation not meeting standard as identified by "no plan"
• Provides clear communication, with use of DataRAP® application, through query to PCP on documentation not meeting standard of basic administrative components to a progress note
• Ensures accuracy of entry by comparing to outcome of diagnoses on eAttestation post validation entry
• Associates attestation sheets received into the DataRAP® database to provide tracking for all markets
• Identifies and reports quality concerns and errors to DataRAP® Clinical Process Quality Analyst for review and education
• Responsible for providing coding support to the DataRAP® Clinical Coding Nurses and to the providers participating in the DataRAP® process
• Performs all other related duties as assigned

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. REQUIRED QUALIFICATIONS:

• High School diploma or GED equivalent
• CPC certification or proof that certification has been obtained within nine months of hire date from the American Academy of Professional Coders
• Knowledge of ICD-9 / ICD-10 CM guidelines and coding
• Ability and willingness to travel (locally and non-locally) as determined by business need
• Proficiency with Microsoft Office applications to include Word, Excel, PowerPoint and Outlook

Preferred Qualifications:

• Some college experience
• 2+ years of medical coding experience with strong attention to detail and a high level of accuracy in a clinical or managed care setting
• Bilingual in Spanish/English
• Strong attention to detail
• Ability to analyze facts and exercise sound judgment when arriving at conclusions
• Ability to effectively report deficiencies with a recommended solution in oral and / or written form
• Ability to perform in a deadline driven environment
• Able to maintain professionalism and a positive service attitude at all times
• Experience with proprietary medical coding systems

CAREERS WITH WELLMED. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team 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.

A Fortune 6 company, we're focused on helping people live healthier lives while making the health system work better for everyone. Here, we seek to empower people with the information, guidance and tools to make personal health choices. We work harder and we aim higher. We expect more from ourselves and each other. And, at the end of the day, we’re doing a lot of good for more than 142 million people worldwide.