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Entry Level Optum Health Coding Risk Adjustment Jobs

Honest Health

Sr. Risk Adjustment Auditor

$82K - $101K/yr

Associate's or Bachelor's degree in Health Information Management, Nursing, or a related clinical field (or equivalent experience) * 5+ years of experience in risk adjustment, medical coding, CDI, or ...

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Entry Level Optum Health Coding Risk Adjustment information

What are the key skills and qualifications needed to thrive as an Entry Level Optum Health Coding Risk Adjustment specialist, and why are they important?

To thrive in an Entry Level Optum Health Coding Risk Adjustment role, you typically need a basic understanding of medical terminology, ICD-10 coding, and healthcare documentation, often supported by a Certified Professional Coder (CPC) or similar certification. Familiarity with coding software, electronic health record (EHR) systems, and risk adjustment methodologies is important for daily tasks. Attention to detail, analytical thinking, and effective communication are vital soft skills for ensuring coding accuracy and collaborating with healthcare providers. These skills and qualifications are essential to ensure precise risk adjustment coding, compliance with regulations, and the financial integrity of healthcare organizations.

What are the primary challenges faced by entry-level coders in Optum Health's risk adjustment team, and how can new hires successfully navigate them?

Entry-level coders in Optum Health's risk adjustment team often encounter challenges such as understanding complex medical terminology, accurately interpreting clinical documentation, and strictly adhering to coding guidelines. Additionally, adjusting to a fast-paced environment with productivity and quality targets can be demanding. New hires can succeed by participating in available training sessions, proactively seeking clarification from experienced team members, and regularly reviewing updated coding standards. Building strong communication with clinicians and fellow coders also helps ensure accuracy and efficiency in coding assignments.

What is an Entry Level Optum Health Coding Risk Adjustment position?

An Entry Level Optum Health Coding Risk Adjustment position is a role within Optum Health focused on reviewing medical records and accurately assigning diagnostic codes to ensure proper risk adjustment for healthcare plans. These professionals help ensure that health plans receive adequate funding based on the health status of their members, which is crucial for organizations participating in Medicare Advantage and other risk-adjusted programs. Entry-level employees in this field typically work under the supervision of more experienced coders, learning industry coding standards and guidelines such as ICD-10-CM. Strong attention to detail, understanding of medical terminology, and compliance with regulations are important aspects of this job.

What is the difference between Entry Level Optum Health Coding Risk Adjustment vs Entry Level Medical Coding Specialist?

AspectEntry Level Optum Health Coding Risk AdjustmentEntry Level Medical Coding Specialist
CertificationsCPR, CPC or equivalent preferredCPC or CCS certification often required
Work EnvironmentHealthcare insurance, payer organizations, risk adjustment teamsHospitals, clinics, outpatient facilities
Job FocusRisk adjustment coding for insurance reimbursement and risk managementClinical coding for medical procedures and diagnoses
Industry UsageHealth insurance, managed careHealthcare providers, hospitals

Entry Level Optum Health Coding Risk Adjustment roles focus on coding for insurance risk adjustment, requiring knowledge of payer guidelines. Entry Level Medical Coding Specialists primarily code clinical procedures and diagnoses for patient records. While both roles involve medical coding, the former emphasizes insurance and risk management, whereas the latter centers on clinical documentation. Understanding these differences helps job seekers target the right position based on their skills and career goals.

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Entry Level Optum Health Coding Risk Adjustment jobs near you
Risk Adjustment Coding Specialist II

Risk Adjustment Coding Specialist II

Millennium Physician Group

Florida, NY • On-site

Full-time

Re-posted 7 days ago

Millennium Physician Group rating

6.3

Company rating: 6.3 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

669th of 886 rated healthcare providers

Job description

Job Description Summary

Responsibilities
Abstract and assign ICD10CM diagnosis codes supported in encounter documentation and work independently with minimal oversight from leadership or higherlevel coders.
Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.
Perform comprehensive reviews of provider actions within the ValueBased Alert Tool (VBAT) to identify outliers and improvement opportunities.
Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist in developing interventions at the provider or regional level.
Keep leadership aware of project activities through written and oral updates;
proactively identify project risks.
Consistently meet or exceed accuracy and productivity benchmarks.
May be assigned additional projects or a higher workload volume than a Level I specialist.

How will you make an impact & Requirements

RISK ADJUSTMENT CODING SPECIALIST

    Qualifications

    • Minimum 2 years of coding or related medical experience, including 1 year of HCC coding.
    • Advanced knowledge of medical terminology, anatomy, physiology, and disease processes.
    • Extensive understanding of ICD10CM conventions, documentation standards, and reimbursement systems.
    • Strong technical skills, including proficiency with MS Office (Excel, Word, Access, PowerPoint).
    • Demonstrated ability to use a variety of electronic medical record systems.
    • Ability to manage a significant workload and meet deadlines with minimal supervision.
    • Strong organizational, analytical, mathematical, and problemsolving skills.
    • Effective written and verbal communication abilities.
    • Experience contributing to project work, educational development, or group presentations.

    What Millennium Physician Group employees say

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