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 TRICARE Coordinator â?? Coder (RHIT or RHIA) - Phoenix, Arizona, United States

   
Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Existing work authorization required for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Nursing - Other
 
Travel: Unspecified 
Accept candidates: from anywhere 
Languages: English - Fluent
 
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 521587 / Latpro-2479008 
Date posted: May-11-2013
State, Zip: Arizona, 85006

Description

This position works under the supervision of the CQM Medical Records Manager. This position is responsible for medical records processing and ensuring timely response to findings related to TRICARE Operations Manual Chapter 7 Section 3 TRICARE Quality Monitoring Contractor (TQMC) interface. This position also supports the Clinical Quality Management (CQM) department in coding activities associated with focused reviews, quality studies, and quality improvement activities. The individual in this role will oversee gathering and shipping medical records requested by the TQMC in the required timeline.       
 
Key Responsibilities include:
  • Process and initiate incoming requests from TQMC for medical records
  • Prepare and transfer medical records to the TQMC to meet contract requirements of delivery receipt within 45 days; prepares and ensure submission of required medical records reporting to meet contract requirements
  • Act as resource for CQM and UM staff for  ICD-9, CPT, and HCPCS coding
  • Receives TQMC Findings reports, obtains responses, and is responsible for ensuring timely submission of responses per contract requirements
  • Organize and maintain CQM files and medical records according to DoD record management requirements
  • Maintain Medical Record tracking database
  • Conducts audits, runs reports and completes analysis within agreed upon deadlines
  • Maintains confidentiality and non-discoverability of all activities
  • Refer cases to Program Integrity, Case Management, and Customer Service as appropriate
  • Manages assigned special projects to completion within target date
  • Utilizes quality system tools/databases to capture relevant data
  • Shares best practices and supports team goals and objectives
  • Drives consistency and efficient processes on the team
  • Participates on medical records committee
  • Performs all other duties as assigned




Requirements

  • Current Registered Health Information Technician (RHIT) certification and/or Registered Health Information Administrator (RHIA)
  • At least 2 years of related coding experience/directly applying codes CPT, ICD-9, DRGs, HCPCS
  • United States Citizenship
  • Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86.
  • Experience with computer and web-based applications
  • Excellent written and verbal communication skills
  • Ability to lead teams
  • Detail oriented and highly organized
  • Ability to work in a rapidly changing environment being adaptable and flexible
 
Additional assets include:
  • Experience in the private medical industry, health insurance or managed care field preferred
  • Familiarity with the military health care delivery system preferred
 
As a requirement of UnitedHealth Group’s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf , (the National Agency Check or “NACâ€).  Successful completion of the NAC process is a requirement for continued employment in this role.  NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense.  Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received.  Failure to obtain final NAC approval will result in termination from this role.
 
 
Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. That’s why UnitedHealthcare is the organization that’s called on to serve them and their loved ones. We’re all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. It’s a genuine opportunity to do your life’s best work.
 
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 
 

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.


 

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