Optum is seeking a Compliance Analyst to perform independent, risk-based coding compliance audits and support coding/billing investigation reviews. This role evaluates procedure coding, documentation, and billing activities for compliance with CMS requirements, official coding guidelines, payer policies, and organizational standards.
The position is fully remote within the U.S. and focuses on audit reporting, root-cause analysis, compliance risk identification, and targeted education based on audit findings.
Requirements & Qualifications
- High school diploma or GED
- One of the following credentials: CPC, COC, CCS, or CCS-P
- 5+ years of outpatient physician coding experience, including CPT, HCPCS, ICD-10, modifiers, and NCCI edits
- 5+ years of healthcare regulatory compliance experience, including Medicare, Medicaid, and state/federal laws governing medical coding
- 3+ years of experience with EHRs and medical record systems
- Advanced proficiency with Microsoft Excel, Teams, PowerPoint, Word, and Outlook
- Strong written and verbal communication skills
- Ability to manage multiple assignments, spreadsheets, documents, and reports
- Ability to gather, analyze, and organize data for medical coding compliance work
- Strong time management and follow-through
Benefits & Perks
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase program
- 401(k) contribution
- Career development opportunities
- Flexible telecommuting within the U.S.
Location
Minnesota, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$60,200 - $107,400
Remote work allowed
Yes
Posted
2 months ago