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.
We are seeking a highly skilled and experienced Senior Director of Physician Coding and Education to lead our medical coding operations and ensure compliance with industry standards. The Senior Director will play a crucial role in providing strategic direction of all coding processes, including educating physicians and clinical staff. This position requires a solid leader with deep knowledge of medical coding, regulatory guidelines, and a proven ability to collaborate across departments to drive accuracy and efficiency in coding practices.
The Senior Director of Physician Coding and Education is responsible for leading the National Coding team that performs the analysis of medical records and applies the appropriate CPT, ICD-10, HCPCS and modifiers to patient medical records. This leader will also be responsible for performance improvement including oversight of audits and education for coders, physicians, and facilities working in conjunction with Compliance. This role will require 20% travel.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. This position will require 20% travel within US only.
Primary Responsibilities:
- Provide strategic leadership and direction for all coding activities, ensuring the accuracy and efficiency of coding operations across all departments. Maintain a high standard of quality in coding processes for all specialties
- Leadership oversight of the coding department including work allocation, production expectations, problem resolution and quality measures. Collaborate with directors and managers to identify and prioritize learning needs of department staff, recommending training and development solutions
- Design and implement the appropriate organizational structure for the National Coding team that can meet the enterprise needs related to coding, physician education, coding audits and quality measures
- Oversee ongoing training programs for physicians to ensure proper documentation practices, coding accuracy, and compliance with coding regulations
- Align opportunities where computer assisted coding can be leveraged for increased efficiency and accuracy for applicable service lines and procedures
- Partner with coding performance improvement leader to conduct routine and comprehensive audits of medical charts to ensure coding accuracy, compliance with ICD-10, CPT, HCPCS codes and modifiers, and adherence to regulatory and payer requirements. Identify discrepancies and areas for improvement, providing feedback and recommendations to coding staff and physicians
- Collaborate with physician practices within the care delivery organizations and other Optum Health businesses to ensure execution of coding opportunities and service level agreement follow-through
- Stay current on changes to coding guidelines. This includes but is not limited to medical necessity policies, yearly coding changes, general medical policies, temporary codes and more
- Review quality control audits and coding function studies to develop any necessary resolution plans
- Connect with all corporate departments to ensure operational functions are aligned with the organization’s strategic goals
- Keep Vice President of National Revenue Cycle team abreast of any changes in coding impacting reimbursement
- Establish communication mechanism for providers to deliver relevant continuous education, feedback on documentation performance, and alignment with guidelines and recommendations
- Leverage data on key coding metrics, denial rates and audit outcomes to drive decision-making and inform strategic planning
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:
- At least 1 of the following licenses: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Professional Coder - Hospital (CPC-H), CCS-P and ICD-10 proficient
- 10+ years of progressive revenue cycle experience including coding
- 10+ years of coding management experience in a fast paced, high-volume environment
- 8+ years of experience building / managing a team
- Experience working with senior level management to establish a vision, optimize processes, deploy technology that enhances outcomes, and ensures operational support for revenue cycle management
- Deep knowledge of healthcare billing, coding, payer rules, and reimbursement methodologies (e.g., Medicare, Medicaid, commercial payers). Familiarity with compliance and regulatory requirements
- Demonstrated leadership skills with a track record of successfully training, mentoring, and developing teams. Ability to inspire a culture of continuous improvement
Skillsets:
- Exceptional strategic thinking, problem-solving, and decision-making skills
- Proven leadership and interpersonal skills with the ability to engage and influence stakeholders at all levels
- Excellent verbal and written communication skills. Ability to effectively communicate with team members, management, and external stakeholders
- Solid understanding of revenue cycle processes, healthcare reimbursement models, and regulatory requirements
- Results oriented with the ability to meet deadlines in a fast-paced, dynamic, project-oriented environment
- Excellent professional presentation and organization skills, including ability to manage an array of people, projects, and deadlines
- Self-motivated, detail oriented, solid analytical and critical-thinking skills
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $147,300 to $282,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
