Acute, Inpatient Coding SME - Remote

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Coding SME is responsible for overseeing facility-based coding operations for Dignity Health. They will work directly with client quality leadership teams and coders to ensure accurate and timely coding while consistently improving the patient, employee and client experience. 

You’ll enjoy the flexibility to work remotely* from anywhere within United States as you take on some tough challenges.

Primary Responsibilities: 

• Maintains and demonstrates expert knowledge of coding, coding operations, coding review of all coding staff and best demonstrated coding practices; drives the integration of Optum360 Coding related business objectives within the client environment
• Identifies & builds consensus for facilitation of system and process standardization, utilization of best practices, work integration, change management, issue resolution, metric development and measurement, and communication related to the key components of coding operations:
• Executes the integration of the Optum360 Coding functions and processes in the facilities they serve
• Leverages standard processes, systems, or other vehicles to reduce waste and cost at the facility while improving SLAs, KPIs (Key Performance Indicators), metrics and the overall client and/or patient experience 
• Works collaboratively with HIM, CDI, and Coding Operations to address coder questions, prebill coding reviews, and prebill quality reviews in a timely manner
• Responsible for facilitating education to coding team on coding updates and trends resulting from audit reviews/patient financial requests 
• Assists Coding Leadership with oversight for processes and initiatives designed to continuously improve DNFB and Coding Revenue Cycle performance and/or efficiency 
• Maintains expert knowledge of coding to ensure high productivity and proficiency standards of performance are achieved and utilizes such skills to meet DNFB and other coding metrics as assigned to meet or exceed targets
• Effectively participates in coding quality assurance/compliance activities that include action plans relevant to audit results including remediation, and education
• Participates actively in leadership forums at the system level and leads such forums and other informational/educational offerings for assigned HIM/Coding/CDI Managers
• Subject Matter Expert of applicable Federal, State, and local laws and regulations, Optum360’s organizational integrity program, standards of conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
• Promotes a service-oriented culture within the organization and assures satisfaction with the quality and amount of support provided for departmental functions, initiatives, and projects

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.

Years of post-high school education can be substituted/is equivalent to years of experience

Required Qualifications:

• 5 years of experience working in the coding industry as a Subject Matter Expert (SME) specifically in acute, inpatient coding
• AAPC or AHIMA (CCS, CPC, RHIT or RHIA) coding credential
• Experience working as a lead, SME or educator within the coding industry 

Preferred Qualifications:

• Experience in outpatient coding 
• Experience in ambulatory coding 
• Experience working collaboratively with CDI and Quality leadership in partnership to improve reimbursement and coding accuracy 
• Proven experience partnering with leadership teams and/or vendors regarding coding guidelines, audits, etc
• Operational knowledge of health care related Federal and State regulations, as well as standards from regulatory agencies and accrediting organizations (e.g., CMS, TJC)
• Proficiency with: Microsoft Excel, Word, PowerPoint, and SharePoint
• Proven ability to influence change and serve as primary change agent
• Ability to travel up to 10% based on business needs

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $67,800 to $133,100 per year. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.

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.