Quality Assurance Auditor - Remote

UnitedHealth Group•Eden Prairie, MN

12h•$24 - $43•Remote

About The Position

This role will provide coding quality auditing services to ensure compliance with Optum and CMS coding guidelines and accuracy of coding data reported. Must maintain compliance with Optum Coding Guidelines/policies. The minimum productivity goal is set by project, with minimum 96%25 coding accuracy rate required. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

Coding Certification required (CPC, COC, CIC, CCS, CCS-P, or RHIT; the CPC-A or CCA designation is not acceptable)
4+ years of recent experience ICD-10-CM coding, preferably in a Managed Care setting, with solid attention to detail, and proficient knowledge of ICD-10-CM coding guidelines.
2+ years of recent Medicare Risk Adjustment experience (HCC coding) with proficient knowledge of CMSHCC model and guidelines
1+ years of recent experience in a coding auditor role– auditing the work of other coders
Compliant Physician query experience/knowledge
Ability to work during normal business hours, Monday-Friday 8am-5pm CST (flexibility to select an earlier or later shift start time, after successful completion of training)
Ability to continuously meet the requirements for a telecommuter, i.e. live in a location that can receive a UnitedHealth Group approved high speed internet connection, have a secure designated office space to maintain PHI, smartphone/device for Multi Factor Authentication purposes, meet or exceed all performance expectations

Nice To Haves

CRC (Certified Risk Coder) in addition to required coding certification
Inpatient coding experience
Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
Excellent organizational, problem solving, and critical thinking skills
Excellent verbal/written communication and interpersonal skills

Responsibilities

Assists with execution of the daily activities of the National Quality Assurance program
Performs first level quality audits on vendor coding results
Performs first level quality audits on Care Delivery coding teams coding results
Provides support and assists all markets within Care Delivery on various coding initiatives, such as concurrent review, query compliance audits and retrospective coding quality reviews
Must be able to work with multiple coding tools and EMR systems
Ensure that Optum Coding Guidelines are consistently applied in all processes
Identifies issues and trends in coding and documentation that affect coding accuracy
Provides input and valuable feedback on audit results
Recommends process improvement
Perform all other related duties as assigned