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Salaried Optum Health Coding Risk Adjustment Jobs in Texas

Risk Adjustment Coding Auditor

Prosper, TX ยท On-site

$25 - $28.50/hr

Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV'

Risk Adjustment Coder II

Houston, TX ยท On-site

$27.69 - $34.61/hr

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and ...

Risk Adjustment Coder II

Houston, TX ยท On-site

$27.69 - $34.61/hr

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and ...

Auditor, Risk Adjustment

Dallas, TX ยท Remote

$82K - $108K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Certified Medical Coder

Houston, TX ยท On-site

$21.50 - $29.25/hr

Certified Risk Adjustment Coder (CRC) * Certified Coding Specialist (CCS) * Registered Health Information Technician (RHIT) * Registered Health Information Administrator (RHIA) * Minimum of three (3) ...

Certified Medical Coder

Houston, TX

$21.50 - $29.25/hr

Certified Risk Adjustment Coder (CRC) * Certified Coding Specialist (CCS) * Registered Health Information Technician (RHIT) * Registered Health Information Administrator (RHIA) * Minimum of three (3) ...

... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...

Value Based Coder II

Houston, TX ยท On-site

$18 - $23.75/hr

... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...

... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...

Value Based Coder II

Houston, TX ยท On-site +1

$25.30 - $35.74/hr

... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy 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 Texas? The most popular types of Optum Health Coding Risk Adjustment jobs in Texas are:
What job categories do people searching Salaried Optum Health Coding Risk Adjustment jobs in Texas look for? The top searched job categories for Salaried Optum Health Coding Risk Adjustment jobs in Texas are:
What cities in Texas are hiring for Salaried Optum Health Coding Risk Adjustment jobs? Cities in Texas with the most Salaried Optum Health Coding Risk Adjustment job openings:

Risk Adjustment Coding Auditor

Vytwo

Prosper, TX โ€ข On-site

$25 - $28.50/hr

Full-time

Posted 25 days ago


Job description

Role type: Risk Adjustment Coding Auditor
Quantity of resources: 2
Duration: 6 months
JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's.
Required skillset:
MS Suite
CPC certified
CRC certified
5+ years of risk adjustment experience