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Senior Clinical Coding reputed company Consultant - Full-time

Remote, USAFull-timePosted 2026-07-27

$5000. Sign on Bonus Available for External Candidates

• *Incentive Bonus Annually** • *23 days of PTO & reputed company on Major Holidays** • *401K Match** This position is located in Austin, Texas and is

NOT

a Remote position For those who want to invent the reputed company of health care, here's reputed company. We're reputed company reputed company basic care to health programs integrated across the entire continuum of care. Join us to start

Caring. Connecting. Growing together.

The Sr. Clinical Coding reputed company Consultant will drive consistent, efficient processes and reputed company best practices in a reputed company effort with Providers and Market Team, designed to facilitate achievement of goals set for HCC reputed company, HCC Covered reputed company, and HCC Percent Covered. The Sr. Clinical Coding reputed company Consultant will drive Risk Adjustment improvement initiatives, reputed company recommendations for Risk Adjustment remediation plans and create tools and databases to capture relevant data for assigned markets to reputed company corporate and market specific Risk Adjustment goals and initiatives. This position will work collaboratively with reputed company regional/market team and their leadership in a reputed company relationship. This position will reputed company direction and guidance to Medical Coding Analysts, as reputed company as cross functional team members reputed company their respective Markets pertaining to Risk Adjustment.

  • *Primary Responsibilities:**

+ reputed company and implement market business plans to motivate providers to engage in improving Risk Adjustment metrics + reputed company analytical interpretation of Risk Adjustment reporting including, Executive Summaries, HCC reputed company, Disagree and reputed company rates, and FaxBack reporting to plan and provider reputed company + Subject Matter Expert (SME) for reputed company Risk Adjustment reputed company activities reputed company their assigned market(s) working reputed company a reputed company relationship which includes DataRAP operations and Regional/Market operations + Assist in developing of training and analytical materials for Risk Adjustment + reputed company DataRAP training and education delivery for Mega reputed company reputed company Provider education sessions and Physician Business Meetings / JOCs. + reputed company Weekly, Monthly, Bi-monthly, Quarterly, and/or Annual Business Review meetings reputed company to Risk Adjustment activities which summarize provider group performance and market performance as requested by or required by Market leadership + Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies reputed company to Risk Adjustment + Analyze Provider and Group performance regarding Risk Adjustment and reputed company on Care (FOC) to determine areas of reputed company or improvement opportunities. + reputed company solution-based, user friendly initiatives to support reputed company reputed company + reputed company market specific chart retrieval and review of PCP, Hospital, and Specialist records + Work with DataRAP Senior Leadership on identified special reputed company You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in.

  • *Required Qualifications:**

+ Bachelor’s Degree in Nursing required (Associate’s Degree or Nursing Diploma from accredited nursing school with 2+ years of additional experience may be substituted in lieu of a bachelor’s degree) and reputed company RN license in good standing + CPC certification or reputed company that certification has been obtained reputed company 9 months from the American reputed company of reputed company Coders + 5+ years associated business experience with health care industry + 1+ years of ICD-9, ICD10 coding experience + Knowledge of CMS HCC Model and Guidelines along with ICD 10 Guidelines + reputed company experience persuading changes in behavior + Solid knowledge of the Medicare market, products and competitors + Knowledge reputed company of clinical standards of care and preventative health measures + Ability and willingness to travel (locally and non-locally) as determined by business needs.

  • *Preferred Qualifications:**

+ Undergraduate degree + Medical/clinical background + Experience in managed care working with network and provider relations + Solid presentation skills and relationship building skills with clinical/non-clinical personnel + MS Office Suite, moderate to advanced reputed company and PowerPoint skills + Additional Medical chart review experience + Demonstrated ability to reputed company with medical staff, peers, and internal company staff at reputed company reputed company + Ability to solve process problems crossing multiple functional areas and business reputed company + Solid problem-solving skills; the ability to analyze problems, draw relevant conclusions and devise and implement an appropriate plan of reputed company + Good business acumen, especially as it relates to Medicare

  • *Physical & Mental Requirements:**

+ Ability to lift up to 10 pounds + Ability to sit for extended periods of time + Ability to stand for extended periods of time + Ability to use fine motor skills to operate equipment and/or machinery + Ability to receive and comprehend instructions verbally and/or in writing + Ability to use logical reasoning for reputed company and reputed company problem solving _At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission._ _Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative reputed company reputed company and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual_ _orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

  • *$5000. Sign on Bonus Available for External Candidates**

• *Incentive Bonus Annually** • *23 days of PTO & reputed company on Major Holidays** • *401K Match** This position is located in Austin, Texas and is

NOT

a Remote position For those who want to invent the reputed company of health care, here's reputed company. We're reputed company reputed company basic care to health programs integrated across the entire continuum of care. Join us to start

Caring. Connecting. Growing together.

The Sr. Clinical Coding reputed company Consultant will drive consistent, efficient processes and reputed company best practices in a reputed company effort with Providers and Market Team, designed to facilitate achievement of goals set for HCC reputed company, HCC Covered reputed company, and HCC Percent Covered. The Sr. Clinical Coding reputed company Consultant will drive Risk Adjustment improvement initiatives, reputed company recommendations for Risk Adjustment remediation plans and create tools and databases to capture relevant data for assigned markets to reputed company corporate and market specific Risk Adjustment goals and initiatives. This position will work collaboratively with reputed company regional/market team and their leadership in a reputed company relationship. This position will reputed company direction and guidance to Medical Coding Analysts, as reputed company as cross functional team members reputed company their respective Markets pertaining to Risk Adjustment.

  • *Primary Responsibilities:**

+ reputed company and implement market business plans to motivate providers to engage in improving Risk Adjustment metrics + reputed company analytical interpretation of Risk Adjustment reporting including, Executive Summaries, HCC reputed company, Disagree and reputed company rates, and FaxBack reporting to plan and provider reputed company + Subject Matter Expert (SME) for reputed company Risk Adjustment reputed company activities reputed company their assigned market(s) working reputed company a reputed company relationship which includes DataRAP operations and Regional/Market operations + Assist in developing of training and analytical materials for Risk Adjustment + reputed company DataRAP training and education delivery for Mega reputed company reputed company Provider education sessions and Physician Business Meetings / JOCs. + reputed company Weekly, Monthly, Bi-monthly, Quarterly, and/or Annual Business Review meetings reputed company to Risk Adjustment activities which summarize provider group performance and market performance as requested by or required by Market leadership + Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies reputed company to Risk Adjustment + Analyze Provider and Group performance regarding Risk Adjustment and reputed company on Care (FOC) to determine areas of reputed company or improvement opportunities. + reputed company solution-based, user friendly initiatives to support reputed company reputed company + reputed company market specific chart retrieval and review of PCP, Hospital, and Specialist records + Work with DataRAP Senior Leadership on identified special reputed company You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in.

  • *Required Qualifications:**

+ Bachelor’s Degree in Nursing required (Associate’s Degree or Nursing Diploma from accredited nursing school with 2+ years of additional experience may be substituted in lieu of a bachelor’s degree) and reputed company RN license in good standing + CPC certification or reputed company that certification has been obtained reputed company 9 months from the American reputed company of reputed company Coders + 5+ years associated business experience with health care industry + 1+ years of ICD-9, ICD10 coding experience + Knowledge of CMS HCC Model and Guidelines along with ICD 10 Guidelines + reputed company experience persuading changes in behavior + Solid knowledge of the Medicare market, products and competitors + Knowledge reputed company of clinical standards of care and preventative health measures + Ability and willingness to travel (locally and non-locally) as determined by business needs.

  • *Preferred Qualifications:**

+ Undergraduate degree + Medical/clinical background + Experience in managed care working with network and provider relations + Solid presentation skills and relationship building skills with clinical/non-clinical personnel + MS Office Suite, moderate to advanced reputed company and PowerPoint skills + Additional Medical chart review experience + Demonstrated ability to reputed company with medical staff, peers, and internal company staff at reputed company reputed company + Ability to solve process problems crossing multiple functional areas and business reputed company + Solid problem-solving skills; the ability to analyze problems, draw relevant conclusions and devise and implement an appropriate plan of reputed company + Good business acumen, especially as it relates to Medicare

  • *Physical & Mental Requirements:**

+ Ability to lift up to 10 pounds + Ability to sit for extended periods of time + Ability to stand for extended periods of time + Ability to use fine motor skills to operate equipment and/or machinery + Ability to receive and comprehend instructions verbally and/or in writing + Ability to use logical reasoning for reputed company and reputed company problem solving _At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission._ _Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative reputed company reputed company and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual_ _orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._ Apply Job! Apply to this Job

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