From Home Optum Health Coding Risk Adjustment Jobs in Delaware

Job Description:

This Position is an entry-level role in Risk Adjustment and will learn to demonstrate general proficiency in the areas of Risk Adjustment Coding for highly regulated government insurance programs such as Medicare Advantage (MA), Medicaid, and the Affordable Care Act (ACA). This analyst will audit approved clinical documentation post-visit to ensure accurate coding practices according to general and risk adjustment coding guidelines as established by the Centers for Medicare and Medicaid (CMS) and Health and Human Services (HHS). Continued employment is dependent on the candidate obtaining CRC Certification from AAPC within 1 year of hire.

Job Essentials

1. Reviews clinical documentation to monitor coding practices and ensure accurate coding and reimbursement. Ensures review decisions are in line with Centers for Medicare and Medicaid (CMS) as well as internal department guidelines.

2. Supports higher level analysts in their responsibilities and research and all internal department functions and processes, as needed.

3. Maintains knowledge of coding workflow and use of available technology.

4. Documents chart review results in a Risk Adjustment database for reporting purposes.

5. Participates in governmental risk adjustment audits for CMS/HHS on a limited basis

6. Effectively manages workload and responsibilities.

7. Develops subject matter expertise.

8. Complies with HIPAA law to maintain data privacy and security.

9. Completes all continuing education requirements needed for certification earned on an ongoing basis.

10. Works with software programs (Microsoft Office products, coding programs, Electronic Medical Records (EMR)).

11. Maintains functional knowledge of general medical terminology, medical acronyms, anatomy and physiology.

Minimum Qualifications

• National Professional Coding Certification from AHIMA or AAPC

• Some work or education experience in medical coding or healthcare

• Functional knowledge or medical terminology, acronyms, anatomy, and physiology

• Demonstrated basic-level experience with Microsoft Office products

• Demonstrated excellent written and verbal communication skills

• Completion of an internal CRC training and competency evaluation no later than one year of hire

• Certified Risk Adjustment Coder (CRC) through AAPC obtained within 1 year of hire

Preferred Qualifications

• CRC certification already obtained

• ICD-CM diagnosis coding experience

Physical Requirements

To see the physical requirements needed to perform the essential functions of this job, please click here.

• Interact with others

• Operate computers and other equipment

• Read monitors and documents

• Remain sitting or standing for long periods of time

Location:

Nevada Central Office

Work City:

Las Vegas

Work State:

Nevada

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$28.06 - $44.20

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here (https://intermountainhealthcare.org/careers/benefits) .

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.