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Salaried Optum Health Coding Risk Adjustment Jobs in Nevada

Senior Coder, Risk Adjustment

Reno, NV · On-site

$24.67 - $36/hr

Prominence Health serves members, physicians, and health systems across Medicare, Medicare ... Additional Coding certification preferred (CCS, CPC, or RHIT) Must be credentialed through AAPC or ...

IPA Consultative Coder

North Las Vegas, NV · On-site

$18 - $23.75/hr

Qualifications: * 3+ years of risk adjustment medical coding experience * CCS, CRC OR CPC ... CenterWell is a leading healthcare services business focused on creating integrated and ...

IPA Consultative Coder

Las Vegas, NV · On-site

$18 - $24/hr

Qualifications: * 3+ years of risk adjustment medical coding experience * CCS, CRC OR CPC ... CenterWell is a leading healthcare services business focused on creating integrated and ...

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Salaried Optum Health Coding Risk Adjustment information

What is a salaried Optum Health coding risk adjustment specialist?

A Salaried Optum Health Coding Risk Adjustment specialist is a healthcare professional employed by Optum Health who reviews medical records and codes diagnoses to ensure accurate risk adjustment. Their work supports proper reimbursement for Medicare Advantage and other risk-based health plans by identifying and coding chronic conditions and other relevant diagnoses. These specialists use their knowledge of ICD-10-CM coding guidelines and risk adjustment methodologies to improve documentation and compliance. Being salaried means they are full-time employees rather than contractors, which often includes benefits and consistent work schedules. Their efforts help ensure health plans are funded appropriately based on the health status of their members.

What are some common challenges faced by professionals in the salaried Optum Health coding risk adjustment role, and how can they be addressed?

One common challenge in the Salaried Optum Health Coding Risk Adjustment role is staying updated with frequent changes in coding guidelines, payer requirements, and risk adjustment models. Additionally, ensuring high accuracy while reviewing complex patient records under tight deadlines can be demanding. To address these challenges, professionals should engage in ongoing education, leverage available training resources provided by Optum, and actively participate in team knowledge-sharing sessions. Collaborating closely with clinical documentation specialists and auditing teams also helps maintain compliance and improve coding quality.

What are the key skills and qualifications needed to thrive as a salaried Optum Health coding risk adjustment specialist?

To excel as a Salaried Optum Health Coding Risk Adjustment specialist, you need a thorough understanding of ICD-10 coding, risk adjustment models, and healthcare compliance, typically supported by a coding certification such as CPC or CRC. Familiarity with electronic health record (EHR) systems, coding software, and data analytics tools is essential. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurately interpreting clinical documentation and collaborating with healthcare teams. These competencies ensure accurate risk adjustment coding, regulatory compliance, and optimal reimbursement for healthcare organizations.

What is the difference between Salaried Optum Health Coding Risk Adjustment vs Medical Coder?

AspectSalaried Optum Health Coding Risk AdjustmentMedical Coder
CertificationsCPH, CCS, or RHIT often preferredCPH, CCS, or RHIT typically required
Work EnvironmentHealthcare organizations, insurance companies, remote optionsHospitals, clinics, outpatient facilities
Job FocusRisk adjustment coding, reimbursement accuracyClinical documentation, coding for billing
Industry UsageHigh in health insurance and managed careCommon in healthcare facilities

While both roles involve medical coding, Salaried Optum Health Coding Risk Adjustment specialists focus on risk adjustment coding to support insurance reimbursements, often working in managed care environments. Medical Coders typically handle clinical documentation coding for billing purposes in healthcare facilities. The roles share certifications and require strong coding skills but differ in their primary focus and work settings.

What are the most commonly searched types of Optum Health Coding Risk Adjustment jobs in Nevada? The most popular types of Optum Health Coding Risk Adjustment jobs in Nevada are:
What are popular job titles related to Salaried Optum Health Coding Risk Adjustment jobs in Nevada? For Salaried Optum Health Coding Risk Adjustment jobs in Nevada, the most frequently searched job titles are:
What job categories do people searching Salaried Optum Health Coding Risk Adjustment jobs in Nevada look for? The top searched job categories for Salaried Optum Health Coding Risk Adjustment jobs in Nevada are:
What cities in Nevada are hiring for Salaried Optum Health Coding Risk Adjustment jobs? Cities in Nevada with the most Salaried Optum Health Coding Risk Adjustment job openings:

Senior Coder, Risk Adjustment

Universal Health Services

Reno, NV • On-site

$18.75 - $23.75/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 8 days ago


Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 253 frontline employees who took The Breakroom Quiz

493rd of 887 rated healthcare providers


Job description

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary: The Senior Coder is responsible for documentation and coding review of medical records where services are rendered at various partnered medical practices. Will work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work will include pre, post and wraparound visit input. The Senior Coder will be required to work occasionally onsite at the provider office and may require travel to out of state for in person provider education and training. The Senior Coder will be required to maintain consistent and reliable methods of communication to accommodate the hours and demands of providers' schedules.

Benefit Highlights:

  • Loan Forgiveness Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program
  • Career development opportunities within UHS and its 300+ Subsidiaries! * More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services:

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

Qualifications and Requirements:

  • University/college degree, or equivalent medical records, claims or billing experience
  • 3+ years in CMS coding and documentation guidelines as well as HCC risk adjustment coding practices
  • CRC Required.
  • Additional Coding certification preferred (CCS, CPC, or RHIT) Must be credentialed through AAPC or AHIMA.
  • 2+ years in Risk Adjustment Coding
  • Experience working in a variety of EMRs and the ability to navigate and pick up EMR applications agree
  • Strong understanding and knowledge of CMS Coding and Documentation Guidelines agree
  • Demonstrated competency in HCC coding practices. agree
  • Proficient with MS Office Suite (Word, Excel, Outlook), Internet and databases agree
  • Knowledge of age-specific needs and elements of disease processes and related procedures required.
  • Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes.
  • Working knowledge of inpatient admission criteria, Medicare reimbursement system and coding systems preferred, but not required.
  • Previous medical office experience preferred.
  • Ability to read and write effectively in English; bi-lingual Spanish preferred
  • Highly organized, proficient critical-thinking and analytical problem-solving skills
  • May be required to be available beyond normal 8-5 working hours, including weekends, to accommodate office and provider hours) and to work occasionally onsite at a provider's office
  • Ability to work independently in a time oriented environment is essential.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS

and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.


What Universal Health Services employees say

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US