Senior Coding Quality & Compliance Leader - Remote

Texas Health Institute; Eden Prairie (MN); Hybrid; USD 73,000 - 130,000; Full time

Benefits offered by this job

Remote work allowed

Telecommuter policy

Comprehensive benefits

Job summary

Optum360 is a remote-friendly leader in coding operations seeking a Senior Coding SME to oversee facility-based coding across the region and drive quality metrics, standardization, and audits to exceed SLAs. The role requires strong client relationships with CDI and Quality teams to improve prebill reviews and reimbursement.

You’ll work remotely from anywhere in the U.S., leveraging extensive experience in coding leadership, enterprise coding workflows, and EMR systems to mentor staff and lead

Qualifications

• High School Diploma/GED
• Current, active coding credential through AAPC or AHIMA
• 5+ years as a subject matter expert in corporate coding leadership role for large multi-site healthcare organizations, both internal and contract as well as remote and/or domestic and global
• 5+ years of experience in coding reviewer role auditing Inpatient and/or Outpatient accounts
• 5+ years of experience working collaboratively with CDI and Quality leadership in partnership to improve reimbursement and coding accuracy
• 5+ years of experience with computer assisted coding technologies and EMR (Electronic Medical Record) coding workflow
• Intermediate level of proficiency with: Microsoft Excel (specifically managing large data sets)
• Intermediate level of proficiency with PowerPoint (specifically creating and presenting for the purpose of training a variety of different audiences)

Responsibilities

• Maintains and demonstrates expert knowledge of coding, coding operations, coding review of all coding staff (domestic and global) and best demonstrated coding practices; drives the integration of Optum360 Coding related business objectives within the client environment
• Identifies & builds consensus for 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, metrics and the overall client and/or patient experience
• Works collaboratively with HIM, CDI, Client, and Coding Operations to monitor day to day coding operations, complete prebill coding reviews, and prebill quality reviews
• Assists Coding Leadership with oversight of processes and initiatives designed to continuously improve coding quality and/or efficiency
• Maintains expert knowledge of coding to ensure high level of accuracy and proficiency standards of performance are achieved to meet or exceed targets
• Effectively leads and participates in coding quality assurance/compliance activities that include action plans relevant to audit results including remediation, education, and when appropriate assisting to create and monitor corrective action plans

Skills

Coding leadership

Coding reviewer

CDI collaboration

EMR coding

Excel

PowerPoint

Education

AAPC/AHIMA credential

High School Diploma/GED

Tools

Microsoft Excel

PowerPoint

Job description

Optum360 is a remote-friendly leader in coding operations seeking a Senior Coding SME to oversee facility-based coding across the region and drive quality metrics, standardization, and audits to exceed SLAs. The role requires strong client relationships with CDI and Quality teams to improve prebill reviews and reimbursement.

You’ll work remotely from anywhere in the U.S., leveraging extensive experience in coding leadership, enterprise coding workflows, and EMR systems to mentor staff and lead