[Hiring] Associate Clinical Documentation Improvement Specialist @UnitedHealth Group

Role Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best.

You will 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 activities.
• 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 experience with acute care hospital clinical RN OR Medical Graduate with CDI.
• Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word, Excel, PowerPoint, and Electronic Medical Records.

Requirements

• 5+ years of acute inpatient hospital coding with certifications.
• 3+ years of CDI experience for an acute care hospital.
• Strong understanding of clinical medicine, pathophysiology, and pharmacology.
• Strong grasp of ICD-10 coding, coding conventions, and guidelines.
• CCDS, CDIP or CCS certification.
• 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).