Address
Form of workOverview:
Responsible for serving as a key resource to the Care Management and hospitalist clinician team for concurrent DRG coding. Provides support to claims and management team. Works closely with management on special projects.
- Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
- Provides feedback to physician director, Care Management, Optum's hospitalist for concurrent admissions on the likely DRG code, DRG outlier status, and DRG reimbursement.
- Serves as a key contact and liaison with clinicians to answer coding questions.
- Provides individualized sessions with clinicians for specific coding issues based on medical chart audit results.
- Maintains database of admissions in which concurrent DRG feedback was provided.
- Upon discharge and claim submission, performs validation and analysis of concurrent DRG feedback.
- Provides updates and status reports to management on a weekly basis.
- Stays abreast of industry coding and compliance issues.
- Participates in coding / auditing discussions to ensure best practice efforts and processes are implemented ensuring maximum reimbursement through appropriate coding.
- Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
- Performs additional duties as assigned.
Knowledge, Skills, and Abilities
- Computer literate.
- Working knowledge of 10-key calculator.
- Working knowledge of general office duties.
- Working knowledge of contracted insurance plans.
- Good verbal and written communication skills. Ability to use correct English grammar and spelling.
- Good telephone skills.
- Customer-service oriented.
- Ability to maintain courteous and friendly demeanor when dealing with the public and co-workers.
- Task-oriented.
- Ability to work in a fast-paced team-oriented environment.
- Bilingual preferred.
- You will be asked to perform this role in an office setting or other company location, however, may be required to work from home temporarily due to space limitations.
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work. (SM)
Diversity creates a healthier atmosphere: Optum and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
