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Coding Quality Analyst - National Remote
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. The OptumHealth Behavioral Solutions (OHBS) PNI Coding Quality Analyst is responsible for coding and auditing services specific to administrative fraud, waste and abuse cases. This includes the analysis, documentation, explanation and translation of medical and behavioral diagnosis and procedures. The Medical Coder/Analyst will support the OHBS PNI in research, issues and inquires that relate to their reviews and policies on Medical Coding/Auditing. 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 6:00 am 6:00 pm. It may be necessary, given the business need, to work occasional overtime. We offer 2 weeks of paid training followed by a 90 day ramp up period. The hours of the training will be based on schedule or will be discussed on your first day of employment. Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent, utilizing most current reference materials to include, but not limited to: Current Procedural Terminology (CPT), Internal Classification of Disease (ICD-9/ICD 10) and Healthcare Common Procedure Coding System (HCPCs) guidelines Documents Decisions on reviews through notations and enters notes in appropriate company systems Ability to discuss and present on decisions made to appropriate internal and external individuals/groups Coordinate with team members to understand trends and schemes related to billing issues/coding trends Youll 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 OR GED Must be 18 years of age OR older Certified Coder AHIMA (CCS, CCS-P, RHIT) or AAPC Certified coder (CPC) 3 years of coding experience in CPT medical coding / auditing or coding review for quality assurance Ability to work any of our 8-hour shift schedules during our normal business hours of 6:00 am 6:00 pm. It may be necessary, given the business need, to work occasional overtime. Preferred Qualifications: Behavioral Health experience Knowledge of CMS 1500 and UB04 data elements Encoder Pro familiarity Telecommuting Requirements: 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. Soft Skills: Strong oral and written communication skills Strong organizational/time management skills and be able to work independently or as a team Ability to meet production unit standards while engaging in multiple priorities Problem solving skills All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy The hourly 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, youll 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 everyoneof every race, gender, sexuality, age, location, and incomedeserves the opportunity to live their healthiest life. Today, however, there
