Optum is seeking a Clinical Quality Analyst to support physician coding quality, documentation accuracy, and compliance.
This role serves as a liaison between coding teams and providers, helping resolve coding and documentation questions, identify trends, and improve compliance through education and audits. The position includes provider education, specialty group meetings, annual audits, targeted follow-up reviews, and support for rebuttals related to audits.
Requirements & Qualifications
Required Qualifications
- High school diploma or GED
- Professional coder certification through AHIMA and/or AAPC (CPC, CCS-P, RHIA, RHIT) maintained annually
- 3+ years of physician medical coding experience using ICD-10, CPT, and HCPCS II in a multi-specialty physician clinic
- 2+ years of residency program/teaching hospital coding experience, including Evaluation and Management and one or more of the following: Urogynecology, ENT, Dermatology
- 2+ years providing expert-level coding guidance to physicians, practitioners, and coders
- Intermediate knowledge of MUE and NCCI classification and reimbursement structures
- Intermediate proficiency with Windows PC environments, Microsoft Excel, and Epic
Preferred Qualifications
- Experience auditing charts in a professional coding environment
- Experience providing physician or coding education
- Experience with Microsoft Teams, Encoder Pro, or similar systems
- Experience with Inpatient/Observation E/M coding
- Intermediate Excel experience
Soft Skills
- Strong verbal and written communication skills
Benefits & Perks
Benefits and Perks
- Telecommute flexibility within the U.S.
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase plan
- 401(k) contribution
- Career development opportunities
Location
Wisconsin, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
3 weeks ago