Payment Integrity Ideation Associate Director APC Coder - Remote

$104,700 - $190,400/Yr

Optum - Minnetonka, MN

Full-time - Mid Level

Remote - Minnetonka, MN

5,001-10,000 employees

Insurance Carriers and Related Activities

About the position

The Payment Integrity Ideation Associate Director APC Coder role at UnitedHealth Group focuses on researching and investigating key business problems through quantitative analyses of healthcare costs and utilization data. This position aims to improve health outcomes by developing cost savings initiatives and influencing leadership to adopt innovative approaches in payment integrity. The role offers the flexibility to work remotely and is integral in advancing health equity on a global scale.

Responsibilities

• Identify, create, and develop a portfolio of cost savings initiatives that drive specific and measurable results for assigned clients while providing timely and meaningful client updates.
• Perform and participate in iterative analytical, experimental, investigative, and other fact-finding work in support of concept development.
• Establish strong matrixed relationships with internal stakeholders to define, align, and deliver payment integrity initiatives in support of assigned clients.
• Influence senior leadership to adopt new ideas, approaches, and/or products.
• Recommend changes to current product development procedures based on market research and new trends.
• Act as an industry thought leader and subject matter expert for medical claims, related trends, pricing, and cost management initiatives.
• Lead concepts/projects from conceptualization to completion.

Requirements

• Coding certification through AAPC or AHIMA with 4+ years of experience in APC coding and Outpatient Reimbursement.
• 4+ years of experience auditing, billing, and/or coding claims within a Payment Integrity domain.
• 4+ years of experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity or Revenue Integrity.
• 3+ years of work experience in highly collaborative and consultative roles, with ability to establish credibility quickly with all levels of management across multiple functional areas.
• 2+ years of experience performing research and analysis of claims data and applying results to identify trends/patterns.
• 2+ years of experience presenting proposals to stakeholders and internal customers.
• Maintains working knowledge of CMS rules and regulations and billing codes and related services.

Nice-to-haves

• Advanced degree in health care or medical field.
• 3+ years of experience in claims adjudication or revenue cycle management.
• 2+ years of experience working in a matrixed and highly adaptive environment handling tight deadlines.
• Solid computer skills: Excel (Pivot Tables, Advanced Formulas, macros, etc..), Visio, PowerPoint, Tableau.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution