Coding Quality Analyst

UnitedHealth Group•Bangor, ME

1d•$29 - $52•Remote

About The Position

The Coding Quality Analyst serves as a liaison between coding teams and providers, providing expert coding guidance, education, and audit support. The role works with Edits and Denials teams to analyze trends and address recurring issues, and partners with clinical leadership to support accurate documentation and coding compliance when new services are introduced. The analyst participates in specialty and physician group meetings, trains new providers, provides annual education on code set updates, and conducts provider audits to validate charges and supporting documentation and identify potential revenue opportunities. The role also provides targeted education and follow-up audits when quality standards are not met, performs ad hoc audits, educates coders and providers on findings and trends, and assists with rebuttals for tri-annual audits. The position is telecommutable from anywhere within the United States, subject to UnitedHealth Group’s Telecommuter Policy. The hourly pay range is $29–$52 based on full-time employment. Pay depends on factors including local labor markets, education, work experience, and certifications. Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and a 401(k) contribution, subject to eligibility requirements.

Requirements

High school diploma or GED.
Professional coder certification credentialed through AHIMA and/or AAPC (CPC, CCS-P, RHIA, or RHIT), maintained annually.
At least 3 years of physician medical coding experience using ICD-10, CPT, and HCPCS II in a multi-specialty physician clinic.
At least 2 years of experience in a Residency Program (teaching hospital), with surgical coding experience in Evaluation and Management and one or more listed specialties.
At least 2 years of experience providing expert-level coding guidance to physicians, practitioners, and coders as needed.
Intermediate knowledge of MUE and NCCI classification and reimbursement structures.
Intermediate proficiency in a Windows PC environment, including MS Excel and Epic.
Ability to communicate effectively face-to-face and in writing.
Telecommuters must adhere to UnitedHealth Group’s Telecommuter Policy.
Candidates must pass a drug test before beginning employment.

Nice To Haves

Experience auditing charts in a professional coding environment.
Experience providing physician or coding education.
Experience with systems such as Microsoft Teams and Encoder Pro.
Experience in Inpatient/Observation E/M coding.
Intermediate-level experience with Microsoft Excel.

Responsibilities

Serve as a liaison between coding teams and providers, delivering expert guidance to resolve inquiries and concerns.
Collaborate with Edits and Denials teams to analyze trends and implement educational initiatives or system edits to address recurring issues.
Partner with clinical leadership when new services are introduced to ensure accurate documentation and coding compliance.
Participate in quarterly specialty and physician group meetings to provide targeted coding education and respond to ad hoc inquiries.
Deliver coding and documentation training for newly onboarded providers.
Provide annual provider education on code set updates.
Conduct annual provider audits to validate charges and supporting documentation and identify potential revenue opportunities.
Provide targeted education and follow-up audits for providers who do not meet established quality standards.
Perform ad hoc audits in response to client requests or identified concerns.
Educate coders and providers on audit findings and emerging trends to promote continuous improvement.
Assist coders and/or supervisors as needed with rebuttals for tri-annual audits.