Coding Quality Analyst – Remote Nationwide

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

Jobs in this function provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.

Hours: Monday – Thursday, four 10-hour shifts in between the hours of 7:00AM – 6:00PM (MST or PST) OR Monday – Friday, 8:00AM – 5:00PM. (MST or PST) Supervisor will determine schedule.

Location: Remote Nationwide

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Supports and implements the organization’s vision, mission and values
• Determines priorities and method of completing daily workload to ensure that all responsibilities are carried out in a timely manner
• Performs all job functions in a professional and courteous manner. This includes answering all general emails timely and providing excellent customer service to internal and external customers while overseeing interactions with senior level employees and managers to validate the information/communication flow is efficient and effective
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies as necessary or required
• Fosters and promotes a culture of service excellence and accountability
• Effectively communicates with providers to clarify diagnoses, procedure coding and documentation requirements, including proper sequencing
• Reviews assigned ICD-10-CM codes, which most accurately describe each documented diagnosis and/ or procedure according to established ICD-10-CM and CPT-4 coding guidelines along with modifier usage and medical terminology
• Monitors all coding accuracy at various levels of detail and maintains coding quality as needed
• Tracks coding issues and reviews coding inaccuracies to highlight areas of improvement. Reports or resolves escalated issues as necessary
• Performs a comprehensive medical records review to assure the presence of all component parts including patient and record identification signatures, dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered
• Monitors, audits and reconciles all documents required for data entry, returns incomplete or questionable documents to generating location or provider
• Provides a high level of technical education and serves as a subject matter specialist regarding coding and documentation
• Supports and educates team members about coding best practices and procedures to meet compliance and regulatory requirements
• Reviews payment denials, underpayments, and payment take backs for appropriateness and guides resolution by resubmission to the insurance carrier, patient billing, or appropriate adjustment
• Collaborates with interdepartmental or cross-functional teams for assigned projects and provides departments with coding issues and updates to be shared with providers to ensure timely and accurate claim payment
• Utilizes audit results to provide data driven feedback to providers and management to improve coding accuracy and identify opportunities for improvement and re-training
• Assists business services with maintenance of data files necessary to perform tasks and translate technical or complex concepts for others and communicate it to team members and to internal line of business clients
• Complies with organizational auditing policies and procedures
• Performs all other duties as assigned

 What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• 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.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED (or higher)
• AAPC or AHIMA certified medical coder with a minimum of CPC credential and not limited to CRC, CPC-P, CCS and COC; RHIT or RHIA (no CPC-A)
• 3+ years of experience as a Certified Professional Coder (CPC) (or other coding certification) with billing office experience 
• 1+ years of experience with Medicare, specialty and outpatient coding 
• 1+ years of experience in medical terminology, Healthcare Common Procedure Coding System (HCPCS), Current Procedural Terminology (CPT) and International Classification of Disease (ICD) coding
• Intermediate level of Microsoft Office experience

Preferred Qualifications:

• 1+ years of content management/development working with clinicians
• 1+ years of training experience within an office setting
• 1+ years of experience in revenue cycle management and denials analysis
• 1+ years of EHR experience with Epic

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

The salary range for this role is $23.70 to $46.35 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. 

 

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

 

 Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 

 

 At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

 

 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

 

 

#RPO #Green