Clinical Documentation Integrity Specialist - National Remote

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

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.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 9:00am – 5:00pm PST. It may be necessary, given the business need, to work occasional overtime or weekends. 

We offer 1-3 months of on-the-job training. The hours during training will be 9:00am to 5:00pm PST, Monday - Friday.  

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Perform concurrent and retrospective chart reviews for improving the overall completeness of clinical documentation
• Keep abreast of current coding trends and maintains up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI current trends.
• Effectively utilizes ICD-10 and related materials to investigate coding issues and produce accurate results
• Conducts daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity
• Provides expert level leadership for overall improvement in clinical documentation by providing proficient level review and assessment, and effectively articulating recommendations for improvement, and the rational for the recommendations
• Actively communicates 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
• Provides complete follow through on all requests for clarification or recommendations for improvement
• Ensures effective utilization of Optum® CDI 3D Technology to document all clarification activity
• Utilizes only the Optum360 approved clarification forms
• Proactively develops a reciprocal relationship with the HIM Coding Professionals
• Engages and consults 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.

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:

• 2 years of CDI experience for an acute care hospital
• Understanding of Clinical medicine, pathophysiology, and pharmacology
• ICD-10 coding, coding conventions, and guidelines
• Must have proficiency using a PC in a Windows environment, including Microsoft Word, Microsoft Excel, Microsoft Power Point and Electronic Medical Records (EPIC)
• Ability to work your shift in Pacific Standard Time zone: Monday - Friday, 9:00am – 5:00pm PST. It may be necessary, given the business need, to work occasional overtime or weekends.
• Must be 18 years of age OR older

Preferred Qualifications:

• 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
  
• CAC experience (Computer Assistant Coding) OR  3M360
• Communication and presentation skills – Physician education or engagement.

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The annual range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $58,300 - $114,300 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.

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.

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