Coding Quality Analyst SME

UnitedHealth Group•Eden Prairie, MN

10d•$29 - $52

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Requirements

High School Diploma/GED
Professional coder certification with credentialing from AHIMA and/or AAPC (CPC, CCS-P, RHIA, RHIT) to be maintained annually
4+ years of experience in revenue cycle operations, specifically Coding and HIM (health information management) support
2+ years Acute outpatient coding experience
Experience with Microsoft Office products

Nice To Haves

Working knowledge of all areas of the revenue cycle.
Detailed knowledge of HIM, Coding, including physician query processes, clinical chart reviews, deficiency analysis, scanning, coding, medical record correction processes, denials, and regulations governing HIM core functions
Proven exposure to EPIC, Meditech and 3M Solventum ideal
Proven solid organizational skills, working effectively in a multi-task-based environment, and with an ability to work both independently and collaboratively
Proven solid leadership, communication, problem-solving, and decision-making skills

Responsibilities

Ensuring accurate and timely coding reviews with a focus on compliance and education.
Daily account reconciliations, audit management, and collaboration with coding and clinical teams.
Prebill reviews and resolving coding disputes.
Coding quality audits, providing coder education, and maintaining client coding guidelines annually.
Supporting various meetings, assisting in agenda preparation, and providing coverage for other SMEs as needed.
Keeping coding quality workflows moving, resolving escalations quickly, supporting coders with education and guidance, maintaining client-specific standards, and participating in recurring quality-related meetings.