Optum is a global organization focused on helping people live healthier lives through technology, care, pharmacy benefits, data, and resources.
The Coding Quality Analyst role is a full-time position with a Monday through Friday schedule. Employees must have flexibility to work any 8-hour shift between 8:00 AM and 5:00 PM CST, with occasional overtime as needed. The position includes 4 weeks of on-the-job training.
This role allows telecommuting from anywhere within the U.S. if the telecommuting requirements are met.
Primary responsibilities
- Review 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 with notations and enter notes into company systems.
- Discuss and present decisions to internal and external individuals and groups.
- 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, 40 hours per week, Monday through Friday, with flexibility for 8-hour shift schedules between 8:00 AM and 5:00 PM CST.
- Ability to work occasional overtime as business needs require.
- 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.
- Encoder Pro familiarity.
Telecommuting requirements
- Ability to keep company-sensitive documents secure.
- Dedicated work area separated from other living areas that provides privacy.
- Must live in a location that can receive UnitedHealth Group approved high-speed internet service.
Soft skills
- Strong oral and written communication skills.
- Strong organizational and time management skills.
- Ability to work independently and 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.
- On-the-job training.
Location
Minnesota, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago