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 expert level coding quality auditing services to ensure compliance with optum and cms coding guidelines and accuracy of coding data reportedThis position is also responsible for timely communication of identified quality issuesThis role will work with management to ensure improvement in coding accuracy and various initiatives related to coding compliance are implementedThe 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:
Executes the daily activities of the clinical performance quality assurance program
Performs second level quality audits on vendor coding results and second level quality audit on coding/query compliance for internal coding teams, ensuring quality assurance auditors are auditing in accordance with guidelines
Review qa findings with quality assurance auditors, as neededProvide coaching and mentorship
Acts as resource for coding questions and issues
Assists with onboarding and training of new quality assurance auditors
Mastery of optum coding guidelines – become subject matter expert
Ensure optum coding guidelines and compliance policies are consistently applied in all processes
Perform higher level compliance and other ad-hoc audits as needed
Identify issues and analyze trends in coding and documentationProvide input and valuable feedback to senior management on audit results in a timely manner
Recommends process improvement
Provides support and assists all markets across care delivery with various coding/auditing initiatives as needed
Must be able to work with multiple coding tools and emr systems
Develops relationships with care delivery organizations and communicates guidelines and requirements to ensure correct coding and improved provider documentation
Cross-functional collaboration with multiple teams
Perform all other related 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.
Required qualifications:
Coding certification from aapc or ahima (cpc, rhit, ccs)
6+ years icd-9/10 coding, with strong attention to detail and high accuracy rate
4+ years medicare risk adjustment/hcc coding
3+ years in a coding auditor or team lead function, reviewing the work of other coders and providing feedback on results
1+ year as a quality assurance auditor within clinical performance
Expert knowledge of icd-10-cm guidelines
Advanced knowledge of cms-hcc model and guidelines
Proficient experience working with multiple emr and coding tool software
Ability to work a flexible schedule to accommodate meetings in various time zones as needed
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
Inpatient coding experience
Crc (certified risk coder) in addition to required coding certification
Experience with provider/coder education
Supervisory experience
Microsoft office proficiency (word, excel, powerpoint & outlook)
Hedis/stars knowledge
Experience with webex or similar virtual meeting tools
Experience using diagnosis coding data and trends to identify training opportunities
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 salary range for colorado residents is $53,300 to $95,100Pay is based on several factors including but not limited to education, work experience, certifications, etcIn 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
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, quality assurance, auditor, coding, telecommute, telecommuter, telecommuting, remote, work from home
