Optum is seeking a Coding Quality Analyst to support medical coding quality reviews and help improve health outcomes through accurate, compliant coding practices.
This is a full-time role (40 hours/week, Monday through Friday) with 8-hour shifts during normal business hours of 8:00 AM to 5:00 PM CST. Occasional overtime may be required based on business needs. The position includes 4 weeks of on-the-job training.
The role allows telecommuting from anywhere within the U.S., provided all telecommuting requirements are met.
Primary responsibilities
- Conduct reviews of records identified as suspicious and/or potentially fraudulent using current coding reference materials, including CPT, ICD-9/ICD-10, and HCPCS guidelines.
- Document review decisions and enter notes into appropriate company systems.
- Discuss and present decisions to internal and external individuals or groups as needed.
- Coordinate with team members to understand trends and schemes related to billing issues and coding trends.
Requirements & Qualifications
Required qualifications
- High school diploma or GED.
- Active and unrestricted coding certification from AHIMA (CCS, CCS-P, or RHIT) or AAPC (CPC).
- 2+ years of coding experience in CPT medical coding.
- 2+ years of medical record auditing experience.
- Ability to work full time, Monday through Friday, with flexibility for scheduled shifts and occasional overtime.
- Must be 18 years of age or older.
Preferred qualifications
- Behavioral health experience.
- Experience with fraud, waste, abuse, and error.
- Knowledge of CMS 1500 and UB04 data elements.
- Familiarity with Encoder Pro.
Telecommuting requirements
- Ability to keep company sensitive documents secure.
- Dedicated work area separated from other living areas and providing privacy.
- Access to a UnitedHealth Group-approved high-speed internet connection.
Soft skills
- Strong oral and written communication skills.
- Strong organizational and time management skills.
- Ability to work independently or as part of a team.
- Ability to meet production standards while managing multiple priorities.
Benefits & Perks
Benefits and perks
- Comprehensive benefits package.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution.
- Training and career development opportunities.
Location
Minnesota, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago