Remote Clinical Coding Analyst: Claims Quality & Compliance

Optum; Plymouth (MN); Remote; USD 68,770,000 - 123,213,000; Full time

Job summary

Optum, a part of UnitedHealth Group in Minnesota, seeks a C&S Clinical Coding Analyst to verify provider claims against medical records and ensure coding accuracy per CPT/HCPCS/ICD guidelines and policies. You will manage a production‑driven caseload, perform quality audits, and provide clinical coding expertise.

This remote role offers telecommuting flexibility from anywhere in the U.S. Requires AHIMA or AAPC certification and 2+ years of coding experience, with strong communication and

Qualifications

• Must hold AHIMA or AAPC coding certification (CPC/CCS/CCS-P).
• 2+ years of AHIMA or AAPC coding experience with CPT/HCPCS/ICD/Modifiers coding.
• 2+ years of health insurance terminology and regulatory guidelines knowledge.
• 1+ years in a metric-driven team environment with daily production/quality standards.
• Intermediate computer skills and ability to troubleshoot problems.

Responsibilities

• Performs quality audits of clinical review cases for CPT, HCPCS, and modifiers.
• Determines accuracy of medical coding and payment recommendations for pre‑payment claims.
• Interpretation of state and federal mandates, benefit language, and policies.
• Apply E/M coding principles to determine appropriate service level.
• Maintain caseload with accountability to quality, utilization and productivity standards.
• Provide clinical support to other investigative and analytical areas.
• Collaborate in team meetings and work independently when needed.

Skills

Strong communication

Attention to detail

Team collaboration

Independent decision making

Education

High School Diploma/GED

AHIMA or AAPC Certified coder (CPC/CCS/CCS-P)

Tools

Microsoft Office

Excel

Adobe Acrobat

Job description

Optum, a part of UnitedHealth Group in Minnesota, seeks a C&S Clinical Coding Analyst to verify provider claims against medical records and ensure coding accuracy per CPT/HCPCS/ICD guidelines and policies. You will manage a production‑driven caseload, perform quality audits, and provide clinical coding expertise.

This remote role offers telecommuting flexibility from anywhere in the U.S. Requires AHIMA or AAPC certification and 2+ years of coding experience, with strong communication and