[Hiring] Associate Clinical Document Improvement Specialist @UnitedHealth Group

Role Description

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

• Perform concurrent and retrospective chart reviews for improving the overall completeness of clinical documentation.
• Keep abreast of current coding trends and maintain up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI current trends.
• Effectively utilize ICD-10 and related materials to investigate coding issues and produce accurate results.
• Conduct daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity.
• Provide expert level leadership for overall improvement in clinical documentation by providing proficient level review and assessment, and effectively articulating recommendations for improvement, and the rationale for the recommendations.
• Actively communicate with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality.
• Provide complete follow through on all requests for clarification or recommendations for improvement.
• Ensure effective utilization of Optum® CDI 3D Technology to document all clarification activity.
• Utilize only the Optum360 approved clarification forms.
• Proactively develop a reciprocal relationship with the HIM Coding Professionals.
• Engage and consult with Physician Advisor /VPMA when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process.

Qualifications

• RN License (BSN Required) OR Medical Degree.
• 3+ years of clinical medicine, pathophysiology, and pharmacology experience.
• 3+ years of experience with ICD-10 coding, coding conventions, and guidelines.
• Intermediate level of experience with Microsoft Office and Electronic Medical Records.

Requirements

• 3+ years of CDI experience for an acute care hospital.
• 5+ years of acute inpatient hospital coding with certifications.
• 5+ years acute care hospital clinical RN experience OR Medical Graduate with CDI experience and CDI certification (CCDS, CDIP).
• CCDS, CDIP or CCS certification.
• BSN degree if a RN.
• CAC experience (Computer Assistant Coding).

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).

Company Description

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.