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UnitedHealth Group Clinical Documentation Analyst - Indianapolis, IN in Indianapolis, Indiana

Find out what it means to be part of an exceptional company that values its employees, its role in health care, and making a difference one patient at a time. Take a look at AmericanHealth Network, part of Optum and explore a new path to your life’s best work.(sm)

This position is responsible for receiving, identifying, and managing all medical record documentation incidents, errors, and other medical records documentation related issues reported by clinicians and other AHN staff members. The position facilitates the timely correction of reported and identified documentation errors, thoroughly analyzes the incidents and errors to determine root cause and any impact the incident or error has had on different areas including patient care, Compliance, Billing, Privacy etc. Further, the position is responsible for providing education and instructions on proper medical records documentation practices and appropriate error correction methods.

Primary Responsibilities:

  • Incident Identification and Investigation:

  • Receives, identifies, reviews, assists, and addresses all medical records documentation incidents and other documentation issues

  • Works with practice managers to collect and gather all necessary and relevant information and data to facilitate; (a) a thorough and complete documentation incident investigation and root cause analysis (b) Uses collected information and data to make informed, accurate, and appropriate incident/error correction decisions

  • Investigates all identified medical records documentation incidents received from all AHN practices (Ohio and Indiana)

  • Provides guidance and acts as a resource to practice managers, clinicians, and all other parties involved in documentation incident/error correction process and other clinical documentation issues

  • Incident Assessment, Analysis & Corrective Action:

  • Collaborates with AHN practice managers, other internal departments and entities including Information Technology, Billing, Compliance, Legal, and the Documentation Issues Resolution Team (DIRT) to resolve identified documentation errors and other medical records documentation related issues

  • Analyzes information and data gathered to determine the impact the incident/error could potentially have on different areas and departments including patient care, compliance, release of information, HIPAA, coding, billing, etc.

  • Determines root cause of all incidents/errors

  • Determines appropriate error correction approach and provides written instructions on how to correct the errors in EHR and EPM as needed

  • Identifies trends and corrective measures to prevent reoccurrence

  • Follows up with practice managers to ensure corrective actions, including staff retraining, are implemented

  • Participates in meetings, including feedback on outstanding issues, presentations for education opportunities and any other needs identified

  • Incident Management:

  • Manages all aspects of the Medical Records Incident/Error correction processes

  • Logs and tracks all reported and independently identified medical records documentation incidents and issues and updates

  • Follows up with managers to ensure timely resolution of incidents

  • Works with appropriate compliance, Legal, and EHR personnel to finalize the correction process for the reported issue

  • Follows up with end users and practice managers to provide or confirm corrective action has occurred

  • Creates and provides reports to internal customers as needed

  • Other duties as assigned

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:

  • Youwill be provisioned with appropriate Personal Protective Equipment (PPE) andare required to perform this role with patients and members on site, as this isan essential function of this role

Preferred Qualifications:

  • Registered Health Information Administrator or Registered Health Information Technician preferred or Certified Medical Assistant with extensive clinical work experience preferred

  • Registered Nurse preferred

  • LPN preferred

  • Three years’ experience in healthcare required; five years’ experience preferred

  • At least one year of experience with electronic health record software, three years of NextGen experience preferred

Knowledge, Skills, and Abilities:

The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations

  • Knowledge of current medical terminology in order to communicate with physicians, staff, and patients

  • Knowledge of medical records documentation rules, regulations, and standards

  • Knowledge of HIPAA regulations and requirements

  • Ability to effectively communicate in oral and written form to a variety of internal audiences

  • Ability to write reports, business correspondence, and local procedure manuals

  • Ability to effectively present information and respond to questions from managers or peers

  • Ability to interact and communicate with a variety of people, both on a one-on-one basis

  • Must be able to travel as needed

  • Ability to handle difficult situations involving physicians and other parties in a professional manner

  • Ability to complete assignments in prescribed timely manner

  • Ability to maintain confidentiality of all medical, financial, and legal information

  • Ability to effectively organize and prioritize work; work independently to manage significant work load

  • Working knowledge of Medicare/Medicaid medical records documentation regulations and procedures, licensing and certification requirements, and other state and federal regulations relating to the health care industry

  • Ability to define problems, collect data, establish facts, and draw valid conclusions

  • Ability to follow direction

  • Ability to think logically in order to troubleshoot, analyze situations, and make appropriate decisions

  • Proficient computer skills, including working knowledge of Microsoft Office Suite, e-mail systems, and web-based programs

  • Ability to handle multiple tasks simultaneously

Physical Demands:

The physical demands described here are representative of those an individual must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Ability to work in a fast-paced office environment

  • Ability to stand and sit for periods of time and to move intermittently throughout the workday

  • Ability to occasionally push, pull, lift, move, and/or carry up to 10 pounds

  • Good speaking and listening skills

  • Strong sensory skills, such as visual acuity, good hearing, and dexterity

  • Ability to perform focused work with close attention to detail

  • Ability to travel as needed

  • Ability to operate office equipment, including computers, copiers, fax machines, and phones

  • Ability to interact with others, both in person and through phone, e-mail, and written correspondence

Opportunities with American HealthNetwork, part of Optum. When you join American Health Network (AHN), you become part of a team that strives to identify and retain the top healthcare professionals in the markets it serves. At American Health Network, we want to be the best health care organization we can be. Our mission is to improve the health of our patients. We’re a physician-led organization, operating over 70 medical offices in Indiana and Ohio, with over 300 providers and 1200 employees. We’re also part of Optum, in the UnitedHealth Group family of businesses, and backed by the resources of a global health care organization working to help people live healthier lives and help make the health system work better for everyone. That’s an important differentiator as more people need our help simplifying the complexities of the American health care system. At the same time, the culture of AHN supports work-life flexibility for employees and places a high value on their physical, emotional, financial and other aspects of well-being.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's bestwork.(sm)

Diversity creates a healthier atmosphere:UnitedHealth Group is an Equal Employment Opportunity/Affirmative Actionemployer and all qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sex, age, national origin, protectedveteran status, disability status, sexual orientation, gender identity orexpression, marital status, genetic information, or any other characteristicprotected by law.

UnitedHealth Group is a drug-free workplace.Candidates are required to pass a drug test before beginning employment.

Job Keywords: Clinical Documentation Analyst, health information administrator, health information technician, licensed practical nurse, registered nurse, certified medical assistant, EMR, EHR, NextGen, Indianapolis, IN, Indiana

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