Senior Coding Quality Analyst

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

Senior Business Analyst, OI Product is responsible for providing Health Information Management, coding, CDI, and general middle revenue cycle subject matter expertise for Optum Clinical Language Intelligence (CLI)™ enabled products. Data Science and CLI software engineers. They analyze CLI enabled product data to contribute to client success, support short and long term operational and strategic goals and business planning. They assist with client implementation, and CLI innovation projects. This position reports to the Director of Product

Primary Responsibilities:

• Collaborates with product management and development team on the impact of long-term trends related to healthcare middle revenue cycle industry trends and requirements (coding, CDI, quality reporting, new technology)
• Assesses and understands customer middle revenue cycle product performance, needs and requirements by interpreting customer performance analytics
• Defines product performance specifications for solutions via thorough root cause analysis and directing to Optum partners for solution deployment
• Assigns the correct ICD-10-CM, ICD-10-PCS, CPT or HCPCS codes to each diagnosis and operative procedure substantiated by documentation contained in the medical record utilizing the current code sets
• Utilizes the provided tools and any other necessary applications for proper coding, ensuring accuracy
• Acts as an internal resource for Health Information Management industry standards
• Works with minimal guidance and escalates appropriate complex scenarios
• Coaches and provides guidance to resources with less experience
• Applies Health Information Management ethical principles and guidelines in the development of product solutions
• Applies knowledge of medical terminology, anatomy and physiology, pathophysiology in the development of product solutions
• Performs all other coding/annotating and auditing project related duties as assigned
• Maintains all credential and certification CEU's
• Comply with all applicable Company policies, procedures, and business directives, changes including those relating to work location, team assignments, work schedules, and flexible work arrangements

Required Qualifications:

• Must have at least one of the following credentials/certifications: CPC, CPC-H, CCS, CCS-P, RCC, CDIP or CDIS
• 5+ years of continuous Health Information Management experience
• Solid working knowledge of healthcare, medical coding, billing companies, quality reporting and general middle revenue cycle technology
• Demonstrate ability to understand the clinical content of a health record
• Demonstrate ability to work independently and also within a team
• Demonstrate ability to communicate effective with software developers, software engineers and other middle revenue cycle subject matter experts
• Demonstrate solid organizational and time management skills

Preferred Qualifications:

• Bachelor's degree
• RHIT and/or RHIA accreditation

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.