Description

Opportunities with Reliant Medical Group, part of the Optum family of businesses. Join a community-based, multi-specialty, physician-led organization where you will work with talented peers on a common purpose: improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well-being as a team member. Join a team at the forefront of value-based care and discover the meaning behind Caring. Connecting. Growing together.

Position Details:

• Location: Remote- Worcester, MA
• Schedule: Full Time
• Department: Medical Coding- Manager

Responsible for the supervision and day-to-day instruction of assigned employees and activities to ensure efficient and accurate claims coding and denials. Assists in maintaining department operations and acts as a leader in Manager's absence.

Primary Responsibilities:

• Assists Management with the daily operations of the coding and denials teams to ensure efficient productivity and quality standards. Distributes and monitors the flow of work for assigned staff
• Directs and supervises assigned personnel including performance evaluations, scheduling, orientation, training, and payroll processing. Makes recommendations on staffing levels, employee hires transfers, promotions, salary changes, discipline, terminations, and other similar actions. Resolves grievances and other personnel problems within position responsibilities
• Coordinates and prioritizes the assignment of tasks and helps resolve technical and operational problems. Evaluates the impact of solutions to ensure goals are achieved
• Provides effective direction, guidance, and leadership over the staff for effective teamwork and motivation, and fosters the effective integration of efforts with organization-wide initiatives
• Provides training and technical assistance to employees within assigned work area
• Assists Manager in ensuring that assigned employees are provided with appropriate resources and materials
• Ensures appropriate follow-up of coding-related payor rejections and denials. Monitors and communicates trends to Manager
• Performs quality control checks on charge documents/encounter forms in preparation for charge entry
• Maintains and reports on productivity, quality standards and processing timelines as established by Revenue Operations Metrics
• Responds to coding related inquiries from providers and support staff and others, as requested
• May perform the duties of the Coding Specialist, as needed, due to employee absence or business need. Coordinates team member time off in a manner the does not negatively impact necessary daily functions
• Must keep abreast of governmental and other payor coding and reimbursement rules and requirements
• Ensures compliance with payor filing deadlines
• Adheres to all governmental and third party compliance issues as directed. Cooperates fully with all governmental and third party insurer audits
• Ensures compliance with regulatory agencies. Develops and maintains procedures necessary to meet regulatory requirement
• Ensures that assigned area comply with established policies, quality assurance programs, safety, and infection control policies and procedures
• Ensures adequate equipment and supplies for assigned area
• Ensures compliance to all health and safety regulations and requirements
• Enhances professional growth and development through educational programs, seminars, etc.
• Performs similar or related duties as required or directed
• Regular, reliable and predicable attendance is required

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School graduate
• Certified Coder: CPC, CCS-P
• Demonstrated leader with 3+ years of supervisory experience
• 3+ years of professional experience, including 2+ years of experience in a managerial/supervisory role
• Proficient in billing software within 6 months
• Extensive knowledge of third party billing and payors, coding principles and denials and appeals processes
• Thorough knowledge of medical terminology and ICD-10 and CPT4 coding
• Solid computer and office skills including phone, keyboard, computer and computer applications, MSOffice, Internet, and E-mail

Preferred Qualifications:

• EPIC experience
• Proven excellent problem-solving ability
• Ability to multi-task in a fast-paced environment
• Solid analytical ability with excellent organizational and communication skills

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

OptumCare 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.

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