Coding Quality Analyst

UnitedHealth Group • Plymouth, MN

2d • $24 - $43 • Remote

About The Position

The Coding Quality Analyst researches and interprets healthcare correct coding using regulatory requirements and guidance related to CMS, CPT/AMA and other major payer policies. They also use internal business rules to prepare written documentation of findings through medical record review. The Coding Analyst possesses an overall understanding of all coding principles, including facility and physician coding and provides health care payers with a total claim management solution. Typically, 90%25 of a Coding Analyst’s time is spent performing coding and documentation review and 10%25 spent performing other tasks as assigned.
This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 6:00pm. It may be necessary, given the business need, to work occasional overtime.
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
• Must have one or more of the following coding credentials: RHIA, RHIT, CCS-P, CCS, CPC, or COC
• 3+ years of experience in medical coding with primary focus in facility and physician coding
• 3+ years of experience in reviewing, analyzing, and researching coding issues
• Intermediate level of proficiency in Microsoft Office skills including Outlook, Excel, and Word (Open/Edit/Create/Save/Send)
• Ability to work full-time, Monday - Friday between 6:00am – 6:00pm including the flexibility to work occasional overtime given the business need
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• Self-starting and independent, able to stay focused while working remotely
• Ability to establish good customer relationships with trust and respect
• High level of attention to written communication
• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Nice To Haves

• Associate degree (or higher) OR equivalent in Health Information Management
• Experience with reimbursement policy and/or claims

Responsibilities

• Conduct coding reviews of medical records and supporting documentation against submitted claims, for individual provider and facility claims, to determine coding and billing accurate for all products
• Process and/or review claims in a timely manner utilizing client specific coding and billing requirements that meet or exceed production and quality goals
• Participate in process improvement activities and encourage ownership of and group participation in improvement initiatives
• Analyze medical documents to evaluate potential issues of fraud and abuse
• Document coding review findings within investigative case tracking system and maintains thorough and objective documentation of findings
• Serve as a coding resource and provide coding expertise and guidance to entire investigation team
• Identify and recommend opportunities for cost savings and improving outcomes
• Coordinate activities with varying levels of leadership including the investigative team, legal counsel, internal and external customers, law enforcement and regulatory agencies, and medical professionals through effective verbal and written communications as needed
• Research and interpret correct coding guidelines and internal business rules to respond to customer inquiries, and monitors CMS and major payer coding and reimbursement policies
• Must be able to take and pass Coding Assessment

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED