Coding Quality Analyst – Remote

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

 

This physician led, patient centric, and data driven business creates value by delivering and facilitating care across the full continuum through high performing networks comprised of owned, managed and contracted physicians, advanced practitioners and other providers. Our system impact extends across physicians, specialty care, urgent care, home health, post-acute transitions, complex care in skilled nursing facilities and palliative care.

 

This position is responsible for prospective and retrospective review of the Electronic Health Record (EHR) to assist providers in more specific and complete documentation and coding. Through interaction with the physicians and other clinicians, this role facilitates improvement in the quality, completeness, and accuracy of the medical record documentation to support severity of illness, medical necessity, risk adjustment factor and level of services rendered.

 

 Schedule: Monday – Friday, 8-hour shift between 7:00 a.m. – 5:00 p.m.  

 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

 
Primary Responsibilities:

• Conducts concurrent reviews of selected patient records to address clarity, completeness, consistency, and precision of clinical documentation
• Demonstrates understanding of clinical documentation requirements to ensure that the severity of illness, risk of mortality, and services provided are accurately reflected in the record
• Serves as a resource on appropriate clinical documentation to support the coded conditions and risk adjustment factors
• Communicates documentation discrepancies and coding definitions to the physicians both written and verbally as needed to clarify clinical documentation in accordance to query standards and/or policies
• Conduct 1:1 educational session with physicians and other healthcare team members related to specific documentation and coding requirements
• Collaborates and educates he multi-disciplinary team, including physicians, nurse practitioners, physician assistants, executive directors, practice managers, coding/billing staff and others regarding clinical documentation and coding best practices
• Utilizes the electronic health record effectively
• Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints
• Participates in quality and performance improvement activities
• Attends meetings and participates on committees as requested
• Reviews current literature and attends training sessions and seminars to keep informed of new developments in the field and to maintain certification
• Performs other related duties and responsibilities as directed

 

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:

• Certified Professional Coder (CPC) or Certified Coding Specialist–Physician (CCS-P) or RHIT
• Coding experience in physician-based settings (physician offices or group practices) or in the payer environment

 

Preferred Qualifications:

• Certified Risk Adjustment Coder (CRC) 
• Knowledge of anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses
• Sound knowledge of medical coding guidelines and regulations
• Expert knowledge in health information documentation, data integrity, and quality
• Expertise in reviewing and assigning accurate medical codes for diagnoses performed by physicians and other qualified healthcare providers in the office setting
• Expert in ICD-10 diagnosis coding
• Keen understanding of the impact of diagnosis coding on risk adjustment payment models
• Apply proper diagnosis code assignment under various risk adjustment models including HCC, CDPS, ACA-HHS and private payer models
• Understand the use of data mining from data captured through risk adjustment coding
• Understand predictive modeling from data captured through risk adjustment coding
• Ability to identify and communicate documentation deficiencies to providers to improve documentation for accurate risk adjustment coding  

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. 

  

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The hourly range for this role is $23.22 to $45.43 per hour. 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.

  

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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.   

  
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.