Healthcare Network Consultant: Coding & Risk Adjustment

RXinsider LTD.; Nashville (TN); Hybrid; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution

Equity stock purchase

Job summary

UnitedHealth Group in Nashville, TN is seeking a Healthcare Coding Specialist to support Medicare Advantage programs, traveling up to 75% to collaborate with providers on documentation and coding improvements. Remote work is possible when not in the field.

The role emphasizes training, RAF optimization, and CMS/HCC guidance, with a healthcare background and CPC-A/CRC preferred. Benefits include comprehensive packages and 401k/equity options.

Qualifications

• 2+ years of healthcare experience with medical terminology.
• Strong data analysis and presentation skills.
• Willingness to travel up to 75% of time in the territory.

Responsibilities

• Function independently, meet providers to discuss Optum tools and programs focused on improving the quality of care.
• Develop provider-specific plans to increase RAF performance and coding specificity.
• Manage end-to-end Risk and Quality Client Programs.
• Provide ICD-10 and CPT-2 coding training to providers and staff.
• Collaborate with clinicians, coders and hospital staff on education efforts.
• Deliver training to groups of clinicians and staff.

Skills

Healthcare background

Travel readiness

Driver's license

Data analysis

Education

CPC-A certification

CRC certification

Tools

MS Office

Job description

UnitedHealth Group in Nashville, TN is seeking a Healthcare Coding Specialist to support Medicare Advantage programs, traveling up to 75% to collaborate with providers on documentation and coding improvements. Remote work is possible when not in the field.

The role emphasizes training, RAF optimization, and CMS/HCC guidance, with a healthcare background and CPC-A/CRC preferred. Benefits include comprehensive packages and 401k/equity options.