Optum is seeking a National Coding Educator to serve as a virtual provider engagement specialist focused on risk adjustment and quality coding. This role supports provider clients by improving documentation, coding accuracy, and compliance through education, chart review, audits, consultation, and training.
The position is remote within the U.S. and works closely with operational and clinical leadership to identify best practices, support coding initiatives, and help ensure diagnoses are coded and documented according to CMS and risk adjustment guidelines.
Key responsibilities include:
- Consulting with healthcare advocates and providers to improve documentation and coding accuracy
- Supporting understanding of CMS-HCC Risk Adjustment and quality reporting requirements
- Identifying providers for chart review and targeted training using analytics
- Performing audits of medical charts and reviewing selected documentation for proper coding
- Providing ICD-10-CM and CPT II coding guidance and feedback
- Developing and delivering coding education, presentations, and training materials
- Educating physicians and staff on documentation practices, coding regulations, and compliance
- Collaborating with internal and external teams on risk adjustment and quality reporting education
- Supporting Optum trainers, tools, presentations, and forum activities
Required qualifications:
- Certified Risk Adjustment Coder (CRC)
- CPC with AAPC or CCS-P with AHIMA, with the ability to obtain AAPC Approved Instructor credential within 6 months
- 5+ years of coding training experience for providers, coders, and billers
- 4+ years of risk adjustment and/or HEDIS/Stars provider education experience
- Experience with office software, coding software, EMR, and abstracting systems
- Advanced proficiency in Excel, PowerPoint, and Word
- Willingness to travel 30% to 50% as needed
- Valid unrestricted driver's license and current auto insurance
Preferred qualifications:
- CPMA certification
- 4+ years of clinic, hospital, and/or managed care experience
- Management experience in a provider practice
- Knowledge of EMR systems
- Knowledge of billing and claims submission processes
Additional strengths:
- Strong communication and presentation skills
- Analytical and business acumen
- Ability to deliver compliant training materials
- Relationship-building skills
- Independent judgment and confidentiality
Benefits and perks mentioned in the posting include:
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase plan
- 401(k) contribution
- Career development opportunities
- Flexible remote work arrangement within the U.S.
Location
Irvine, California, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$91,700 - $163,700
Remote work allowed
Yes
Posted
1 month ago