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Entry Level Optum Health Coding Risk Adjustment Jobs

Medica

Risk Adjustment Healthcare Analyst

Minnetonka, MN

$90.50K - $155.20K/yr

The Risk Adjustment Healthcare Analyst (P3) is a senior-level individual contributor responsible ... coding accuracy, and regulatory compliance. Operating with minimal supervision, the analyst ...

Medica

Risk Adjustment Healthcare Analyst

Madison, WI

$90.50K - $155.20K/yr

The Risk Adjustment Healthcare Analyst (P3) is a senior-level individual contributor responsible ... coding accuracy, and regulatory compliance. Operating with minimal supervision, the analyst ...

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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
Infographic showing various Entry Level Optum Health Coding Risk Adjustment job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 83% Full Time, and 16% Part Time. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution.
Risk Adjustment Certified Coder

Risk Adjustment Certified Coder

UNIVERSITY PHYSICIANS ASSOC INC.

Knoxville, TN • On-site

$21.50 - $29.25/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home.

Candidate must be located in the Knoxville, TN region. University Health Networ k is seeking a full-time Certified Medical Coder to join our team. This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding HCC diagnoses using ICD-10-CM guidelines.

CPT and E/M experience is not required for this role. Essential Duties and Responsibilities (this list does not include all duties assigned) Performs coding services while meeting daily production and quality goals Conduct thorough reviews of clinical documentation to ensure accuracy and compliance with coding standards. Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers for professional services.

Collaborate with healthcare providers to clarify diagnoses and procedures to ensure accurate coding. Use CMS and HHS risk adjustment mapping tools to identify HCC coding and documentation opportunities Participate in ongoing education and training to stay current with coding updates and guidelines Actively participates in designated team meetings Consistently meets coding productivity and accuracy standards while managing different responsibilities and workflows. If unable to maintain productivity and accuracy standards, team members will work onsite at the UHN office until standards are met and maintained.

Partners with providers, practice staff, and UHN Coding team to improve quality and efficiencies in coding and documentation Educates and coaches providers on compliant coding and documentation practices Facilitates and supports a culture of compliance, ethics, and integrity Recognized as an expert in medical coding, documentation, and risk adjustment compliance Interacts effectively and builds respectful working relationships across the organization. Maintains HIPPA Guidelines for privacy Respects the privacy of all patients 100% of the time Understands and abides by HIPAA laws and regulations and UPA HIPAA policy at all times Obtains consent to release protected health information Reports all HIPAA issues to the Supervisor Remains current on coding rules and guidelines Remains up to date with official AMA ICD-10-CM, CPT, and HCPCS coding guidelines and regulations, Medicare, other MA and commercial plans, and internal guidelines Remains up to date with CMS and HHS HCC risk adjustment models Meets CEU requirements and remains in good standing with AAPC/AHIMA certifications Requirements Current CPC or RHIT certification required. CRC required within 6 months of hire Preferred at least two years of E/M and professional medical coding experience in an ambulatory care setting.

Preferred experience and knowledge of HCC coding, knowledge related to chronic illness diagnosis, treatment, and management Must be a team player with effective written and verbal communication, relationship-building, and interpersonal skills Must be initiative-taking, highly organized, and have excellent time management Must possess good problem solving and critical thinking skills Exceptional attention to detail and proficiency in Microsoft Outlook (Outlook, Word, Excel, and PowerPoint) Demonstrates integrity by adhering to high standards of personal and professional conduct #J-18808-Ljbffr

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