Coding Quality Analyst - Remote

Optum; Kansas City (MO); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading health care company seeks a Coding Quality Analyst to enhance clinical documentation and coding accuracy, ensuring compliance with standards. This remote position allows flexibility while candidates contribute to quality assurance and improvement of health records, collaborating with healthcare teams across the nation.

Benefits

Comprehensive benefits package

401k contribution

Incentive and recognition programs

Equity stock purchase

Qualifications

• Required coding certifications and experience in physician-based settings.
• Preferred knowledge of anatomy, medical terminology, and coding guidelines.
• Understanding of risk adjustment models and documentation requirements.

Responsibilities

• Conduct concurrent reviews to ensure documentation clarity and accuracy.
• Educate physicians on coding requirements and discrepancies.
• Participate in quality improvement activities.

Skills

Clinical documentation

Coding accuracy

Communication skills

Data integrity

Education

Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCS-P) or RHIT

Job description

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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

This physician led, patient centric, and data driven business creates value by delivering and facilitating care across the full continuum through high performing networks comprised of owned, managed and contracted physicians, advanced practitioners and other providers. Our system impact extends across physicians, specialty care, urgent care, home health, post-acute transitions, complex care in skilled nursing facilities and palliative care.

This position is responsible for prospective and retrospective review of the Electronic Health Record (EHR) to assist providers in more specific and complete documentation and coding. Through interaction with the physicians and other clinicians, this role facilitates improvement in the quality, completeness, and accuracy of the medical record documentation to support severity of illness, medical necessity, risk adjustment factor and level of services rendered.

Schedule: Monday - Friday, 8-hour shift between 7:00 a.m. - 5:00 p.m.

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

Primary Responsibilities

• Conducts concurrent reviews of selected patient records to address clarity, completeness, consistency, and precision of clinical documentation
• Demonstrates understanding of clinical documentation requirements to ensure that the severity of illness, risk of mortality, and services provided are accurately reflected in the record
• Serves as a resource on appropriate clinical documentation to support the coded conditions and risk adjustment factors
• Communicates documentation discrepancies and coding definitions to the physicians both written and verbally as needed to clarify clinical documentation in accordance to query standards and/or policies
• Conduct 1:1 educational session with physicians and other healthcare team members related to specific documentation and coding requirements
• Collaborates and educates he multi-disciplinary team, including physicians, nurse practitioners, physician assistants, executive directors, practice managers, coding/billing staff and others regarding clinical documentation and coding best practices
• Utilizes the electronic health record effectively
• Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints
• Participates in quality and performance improvement activities
• Attends meetings and participates on committees as requested
• Reviews current literature and attends training sessions and seminars to keep informed of new developments in the field and to maintain certification
• Performs other related duties and responsibilities as directed
  
  

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

• Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCS-P) or RHIT
• Coding experience in physician-based settings (physician offices or group practices) or in the payer environment
  
  

Preferred Qualifications

• Certified Risk Adjustment Coder (CRC)
• Knowledge of anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses
• Sound knowledge of medical coding guidelines and regulations
• Expert knowledge in health information documentation, data integrity, and quality
• Expertise in reviewing and assigning accurate medical codes for diagnoses performed by physicians and other qualified healthcare providers in the office setting
• Expert in ICD-10 diagnosis coding
• Keen understanding of the impact of diagnosis coding on risk adjustment payment models
• Understand the use of data mining from data captured through risk adjustment coding
• Understand predictive modeling from data captured through risk adjustment coding
• Proven ability to apply proper diagnosis code assignment under various risk adjustment models including HCC, CDPS, ACA-HHS and private payer models
• Proven ability to identify and communicate documentation deficiencies to providers to improve documentation for accurate risk adjustment coding
• Reside in Kansas City KS or Kansas City MO
• 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 $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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 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.

OptumCare 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.

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

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Quality Assurance

• Industries

  Hospitals and Health Care

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