Coding Quality Analyst

UnitedHealth Group•Plymouth, MN

1d•Remote

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. The Coding Quality Analyst position is full time 40hours/week Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm CST. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Requirements

High School Diploma/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 40hours/week Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm CST. It may be necessary, given the business need, to work occasional overtime
Must be 18 years of age OR older
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Strong oral and written communication skills
Strong organizational/time management skills and be able to work independently or as a team
Ability to meet production unit standards while engaging in multiple priorities
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Nice To Haves

Behavioral Health experience
Experience with fraud, waste, abuse, and error
Knowledge of CMS 1500 and UB04 data elements
Encoder Pro familiarity

Responsibilities

Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent, utilizing most current reference materials to include, but not limited to: Current Procedural Terminology (CPT), Internal Classification of Disease (ICD-9/ICD 10) and Healthcare Common Procedure Coding System (HCPCS) guidelines
Documents Decisions on reviews through notations and enters notes in appropriate company systems
Ability to discuss and present decisions made to appropriate internal and external individuals/groups
Coordinate with team members to understand trends and schemes related to billing issues/coding trends