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Coding Quality Analyst

Optum

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.

This full-time (40 hours/week Monday - Friday) Coding Quality Analyst position involves:

  • Conducting reviews on records identified as suspicious and/or potentially fraudulent using CPT, ICD-9/ICD-10, and HCPCS guidelines
  • Documenting decisions through notations and company systems
  • Presenting decisions to internal and external individuals/groups
  • Coordinating with team members on billing issues and coding trends

Training includes 4 weeks of on-the-job instruction aligned to your schedule. Flexibility to work any 8-hour shift within 8am - 5pm CST is required, with occasional overtime possible.

This role offers the flexibility to telecommute from anywhere within the U.S. with requirements for a secure, dedicated workspace and high-speed internet.

Qualifications include:

  • High School Diploma/GED
  • Active and unrestricted coding certification from AHIMA (CCS, CCS-P or RHIT) or AAPC (CPC)
  • 2+ years CPT medical coding and medical record auditing experience
  • Ability to work full time Monday-Friday with flexible shifts

Preferred qualifications:

  • Behavioral Health experience
  • Knowledge of fraud, waste, abuse, CMS 1500, UB04 data elements, and Encoder Pro

Strong communication, organizational, and time management skills are essential. Must be able to meet production standards while managing multiple priorities.

Requirements & Qualifications
  • High School Diploma or GED
  • Active and unrestricted coding certification: AHIMA (CCS, CCS-P, or RHIT) or AAPC (CPC)
  • Minimum of 2 years experience in CPT medical coding
  • Minimum of 2 years medical record auditing experience
  • Flexibility to work full-time, Monday to Friday, 8 am – 5 pm CST shifts with occasional overtime
  • Must be 18 years or older

Preferred:

  • Behavioral Health experience
  • Experience with fraud, waste, and abuse
  • Knowledge of CMS 1500 and UB04 data elements
  • Familiarity with Encoder Pro

Telecommuting requirements include maintaining information security and a dedicated secure work area with approved high-speed internet.

Benefits & Perks
  • 4 weeks on-the-job training
  • Flexible telecommuting from anywhere within the U.S.
  • Comprehensive benefits package including incentive and recognition programs, equity stock purchase, and 401k contributions (subject to eligibility)

Equal Opportunity Employer committed to diversity and inclusion.

Drug-free workplace with pre-employment drug testing.

Location

Minnesota, US

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

Yes

Posted

3 weeks ago

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