Coding [h1.location_city]

Coding Strategy Lead

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

The Coding Strategy Lead serves as the primary Medical Coding Subject Matter Expert (SME) for Revenue Cycle Management (RCM) Center of Excellence. This role is responsible for developing and executing coding strategies, ensuring compliance with regulatory and coding changes, managing regulatory complaints, and maintaining a compliant charge master aligned with federal and state regulations. In addition, this position partners closely with Denial Prevention and Payer Solutions teams to address root causes of denials requiring coding expertise. As a key leader within the organization, you will influence change across clinical and non-clinical teams at multiple levels and functions within one or more business units.

Success in this role will be measured by :

• Improved initial and final denial write-off rates
• Reduced accounts receivable (A / R) aging
• Decreased appeals

You will collaborate with operations to drive coding strategies for systemic billing issues impacting all MPP clients. Responsibilities include day-to-day operations management, oversight of escalated issues, development of resolution plans, risk mitigation, and creation of growth strategies through opportunity assessments. This role carries accountability for both financial and non-financial outcomes, requires regular client engagement, and ensures adherence to operational performance agreements and regulatory compliance. Additional responsibilities include developing presentations and materials, prioritizing work queues, and creating contingency plans for missed deliverables. The role also leads regulatory complaint resolution and represents RCM Operations in Joint Operating Committee (JOC) calls with payers to address systemic misalignments.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities :

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 :

Preferred Qualifications :

Additional Qualifications :

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline : This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.