North American Medical Management, California, Inc. (NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.
The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets
This Senior Medical Coder will provide coding and auditing services for providers. This includes the analysis and transition of medical diagnoses, clinical procedures, injuries, or Illnesses into designated medical codes.
Schedule for Medical Coder-Risk Adjustment: Monday - Friday / 7:00am - 3:30pm or 8:00am -4:30pm
*This position has potential to be transitioned to a full time telecommuting Sr. Coding position, BUT you must reside locally in San Diego for provider office travel.
- Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether a) the diagnosis codes are supported by the documentation and agree with ICD 10 Guidelines for Coding and Reporting
- Review all medical record documentation for HEDIS and STARs capture and closure. Participate in and support internal and external prospective and retrospective reviews and audits
- Educate and advise providers and their staff on proper code selection, documentation guidelines as well as assist with training and education for new hires
- Identify training needs, prepare summary reports and conduct coaching as appropriate for clinicians and other staff to improve the quality of the documentation to accurately reflect the burden of illness for our patients
- Serve as project and process SMEs when needed
- High school education or GED
- AAPC or AHIMA certified medical coder with a minimum of CPC credential and not limited to CRC, CPC-P, CCS and COC
- 3+ years of experience in medical coding
- 1+ years of HCC coding experience
- Ability to manage significant work load, and to work efficiently under pressure meeting established deadlines with minimal supervision.
- Basic Microsoft office skills: Word, Excel, PowerPoint
- Ability to travel locally to various IPA sites
- Advanced understanding of medical terminology, pharmacology, body systems / anatomy, physiology and concepts of disease processes
- 1 year of HCC coding in Medicare
- Ability to code from a variety of electronic medical records systems
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. 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. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: CPC, HCC, Medicare, CCS, medical terminology, disease process, travel, IPA, San Diego, CA, California