Acute Hospital Inpatient Coding Auditor - Remote

UnitedHealth Group•Eden Prairie, MN

9d•Remote

About The Position

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services. Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification and CMS MS-DRG system. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, official coding guidelines and industry standards. This individual will provide education to coders on audit results, utilize their expertise to research and respond to complex inpatient coding questions, and evaluate audit results to recommend corrective actions. The individual will have the expertise to respond to client requests to conduct ad hoc coding audits. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

Coding Certification from AHIMA or AAPC such as Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Specialist (CCS); or Certified Inpatient Coder (CIC)
3+ years of acute inpatient hospital coding experience using ICD-10-CM/PCS classification in an academic medical center or 2+ years of inpatient coding audit experience
1+ years of current experience / knowledge of acute hospital official coding guidelines, the ICD-10-CM/PCS classification system, MS/APR-DRG systems, and American Hospital Association (AHA) Coding Clinic® for ICD-10-CM/PCS
1+ years of experience with common electronic health records (EHR), encoder/grouper and computer assisted coding applications
Experience with Microsoft Office applications, particularly Excel, Word, Outlook, and Teams

Nice To Haves

6+ years of inpatient coding audit experience
Experience using the Optum computer assisted coding (eCAC) product, and/or other common CAC/encoder software applications
Experience using electronic health record (EHR) applications such as Cerner and Epic
Proven current knowledge and current or past experience coding acute hospital outpatient accounts such as outpatient surgery and emergency room (ED) encounters using CPT®

Responsibilities

Perform coding quality audits in support of Optum Insight's Learning & Performance Program and client expectations
Analyze and interpret documentation from inpatient medical records
Clearly document audit findings, cite appropriate coding guideline references and calculate error rates
Provide feedback and education as appropriate depending on findings
Articulate audit findings appropriate for audience. Prepare written audit reports as needed summarizing audit findings and any corrective action necessary to mitigate risk
Serve as an expert coding resource to client organizations and provide expert coding guidance
Conduct ad hoc coding audits as requested
Stay up-to-date on relevant official coding guidelines, Coding Clinic®, and other industry official guidance
Research, develop and present coding education to coders and management as requested