Job details
Job type full-time
Full job description
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you getLeading edge technology in an industry that`s improving the lives of millionsHere, innovation isn`t about another gadget, it`s about making health care data available wherever and whenever people need it, safely and reliablyThere`s no room for errorJoin us and start doing your life`s best work.(sm)
This role will provide coding quality auditing services to ensure compliance with optum and cms coding guidelines and accuracy of coding data reportedWill review provider’s documentation to identify query opportunitiesMust maintain compliance with optum coding guidelines/policiesThe minimum productivity goal is set by project, with minimum 96% coding accuracy rate required.
You’ll enjoy the flexibility to telecommute* from anywhere within the u.sAs you take on some tough challenges.
Primary responsibilities:
Assists with execution of the daily activities of the enterprise quality assurance program
Performs first level quality audits on vendor coding results
Identifies provider query opportunity, creates and sends compliant query to rendering provider
Provides support and assists on various coding initiatives, such as concurrent review, query compliance audits and retrospective coding quality reviews
Must be able to work with multiple coding tools and emr systems
Ensure that optum coding guidelines are consistently applied in all processes
Identifies issues and trends in coding and documentation that affect coding accuracy
Provides input and valuable feedback on audit results
Recommends process improvement
Perform all other related duties as assigne d
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:
Associate degree or equivalent experience
Coding certification (cpc, coc, cic, ccs, ccs-p, or rhit; the cpc-a or cca designation is not acceptable)
4+ years recent experience icd-9/10 coding, preferably in a managed care setting, with solid attention to detail and high accuracy rate
2+ years recent medicare risk adjustment experience (hcc coding)
1+ years recent experience in a coding auditor role– auditing the work of other coders and providing feedback/coaching
Expertise in compliant querying practice and guidelines
Proficient knowledge of cms-hcc model and guidelines
Icd-10-cm proficient
Ability to work during normal business hours, monday-friday 8am-5pm cst (flexibility to start 8-hour shift earlier or later after successful completion of training)
Ability to continuously meet the requirements for a telecommuter, i.eLive in a location that can receive a unitedhealth group approved high speed internet connection, have a secure designated office space to maintain phi, meet or exceed all performance expectations
Preferred qualifications:
Bachelor’s degree
Crc (certified risk coder) in addition to coding certification
2+ years of coding experience working in a provider’s office
Inpatient coding experience
Microsoft office proficiency (word, excel, powerpoint & outlook)
Knowledge of hedis/stars
Excellent organizational, problem solving, and critical thinking skills
Excellent verbal/written communication and interpersonal skills
Unitedhealth group requires all new hires and employees to report their covid-19 vaccination status.
Careers with optumHere`s the ideaWe built an entire organization around one giant objective; make health care work better for everyoneSo when it comes to how we use the world`s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serveOptum, part of the unitedhealth group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potentialFor you, that means working on high performance teams against sophisticated challenges that matterOptum, incredible ideas in one incredible company and a singular opportunity to do your life`s best work.(sm)
*all telecommuters will be required to adhere to unitedhealth group’s telecommuter policy.
Colorado residents only : the hourly range for colorado residents is $20.77 to $36.88Pay is based on several factors including but not limited to education, work experience, certifications, etcAs of the date of this posting, in addition to your salary, uhg offers the following benefits for this position, subject to applicable eligibility requirements: health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; employee assistance program; pto; and employee-paid critical illness and accident insurance.
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 workplaceCandidates are required to pass a drug test before beginning employment.
Job keywords: quality assurance auditor, coding, telecommute, work from home, optum, telecommuter, telecommuting, work at home, work from home, remote
