Remote C&S Clinical Coding Analyst: Precision Claims Review

Taleo; Minnesota; Remote; USD 50,000 - 90,000; Full time

Job summary

UnitedHealth Group is seeking a C&S Clinical Coding Analyst to review medical records and determine the accuracy of provider claims. The role requires AHIMA/AAPC certification and 2+ years of coding experience, with a focus on CPT/HCPCS coding and regulatory guidelines.

The position offers remote work from anywhere in the U.S., with a production-driven environment and adherence to compliance timelines. Strong analytical and communication skills are essential for success.

Qualifications

• High School Diploma/GED required.
• AHIMA or AAPC coder certification (CPC, CCS, CCS-P) required.
• 2+ years of AHIMA/AAPC coding experience with CPT/HCPCS/ICD/Modifiers.
• 2+ years knowledge of health insurance terms and regulatory guidelines.
• 1+ year in a metric-driven team environment.

Responsibilities

• Perform quality audits of CPT/HCPCS/modifier codes on claims.
• Determine coding accuracy and payment recommendations for pre-payment claims.
• Interpret state/federal mandates and policies in clinical reviews.
• Apply E/M coding principles to determine appropriate service levels.
• Ensure compliance with policies and contract requirements.
• Identify aberrant billing patterns and potential fraud or abuse.
• Manage daily case reviews with quality and productivity targets.
• Provide clinical support to investigative and analytical teams.
• Participate in department meetings and collaborate as needed.
• Work independently and with business partners to obtain information.

Skills

Analytical mindset

Strong communication

Team collaboration

Education

High School Diploma/GED

AHIMA/AAPC certified coder

Tools

Microsoft Office

Adobe applications

Job description

UnitedHealth Group is seeking a C&S Clinical Coding Analyst to review medical records and determine the accuracy of provider claims. The role requires AHIMA/AAPC certification and 2+ years of coding experience, with a focus on CPT/HCPCS coding and regulatory guidelines.

The position offers remote work from anywhere in the U.S., with a production-driven environment and adherence to compliance timelines. Strong analytical and communication skills are essential for success.