Clinical Quality Analyst – Remote in MN or WI

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.

 

This position provides coding education and direction through the training of providers and coding staff. Will create, design, and deliver education and support based off new and changing correct coding guidelines, third party payer regulations, audit findings, and provider reports.

This position is full time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am – 4:30 pm. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule.

 

If you are located in MN or WI, you will have the flexibility to work remotely* as you take on some tough challenges.

 

Primary Responsibilities:

• Serves as a coding resource for providers, coders, and other internal customers. Identifies trends, areas of improvement, and potential compliance issues.
• Reviews compliance findings and performs corrective action plan monitoring.
• Creates provider summaries from audits and provider reports.
• Designs and delivers education and support for providers. Creates, maintains, and communicates coding procedures and billing guidelines in relation to coding and regulatory requirements.
• Other duties as assigned.

 

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.

• High Diploma/GED
• Must be 18 years or older.
• 2+ years of Medical Coding experience 
• AHIMA or AAPC certified coder – (RHIT, RHIA, CPC, or CCS)
• Ability to work Monday – Friday, 08:00AM – 04:30PM CST

• 2+ years of current procedural terminology (CPT) and health care common procedure coding system (HCPCS) experience. 
• 2+ years of International Classification of Diseases, tenth revision (ICD-10-CM) experience Licenses/Certifications 

• Reside within the state of Minnesota or Wisconsin
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.