Quality Assurance Auditor - Remote

Coding Quality Auditor

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.

This role will provide coding quality auditing services to ensure compliance with Optum and CMS coding guidelines and accuracy of coding data reported. Must maintain compliance with Optum Coding Guidelines/policies. The minimum productivity goal is set by project, with minimum 96% coding accuracy rate required.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Assists with execution of the daily activities of the National Quality Assurance program
• Performs first level quality audits on vendor coding results
• Performs first level quality audits on Care Delivery coding teams coding results
• Provides support and assists all markets within Care Delivery 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 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 required (CPC, COC, CIC, CCS, CCS-P, or RHIT; the CPC-A or CCA designation is not acceptable)
• 4+ years of recent experience ICD-10-CM coding, preferably in a Managed Care setting, with solid attention to detail, and proficient knowledge of ICD-10-CM coding guidelines.
• 2+ years of recent Medicare Risk Adjustment experience (HCC coding) with proficient knowledge of CMSHCC model and guidelines
• 1+ years of recent experience in a coding auditor role- auditing the work of other coders
• Compliant Physician query experience/knowledge
• Ability to work during normal business hours, Monday-Friday 8am-5pm CST (flexibility to select an earlier or later shift start time, after successful completion of training)
• Ability to continuously meet the requirements for a telecommuter, i.e. live in a location that can receive a UnitedHealth Group approved high speed internet connection, have a secure designated office space to maintain PHI, smartphone/device for Multi Factor Authentication purposes, meet or exceed all performance expectations

Preferred Qualifications:

• CRC (Certified Risk Coder) in addition to required coding certification
• Inpatient coding experience
• Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
• Excellent organizational, problem solving, and critical thinking skills
• Excellent verbal/written communication and interpersonal skills

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24.00 to $43.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.