Remote Clinical Quality & Coding Analyst

Taleo; Eden Prairie (MN); Remote; USD 40,000 - 72,000; Full time

Benefits offered by this job

Telecommuter Policy

Job summary

UnitedHealth Group is seeking a Clinical Quality Analyst: OptumInsight SME to provide expert coding guidance, education, and support across health systems. This role analyzes trends, educates providers, and ensures accurate documentation and compliance with ICD-10, CPT, and HCPCS guidelines.

You’ll work remotely from anywhere in the U.S. and collaborate with Edits and Denials teams, leadership, and auditors to improve revenue integrity and quality.

Qualifications

• AHIMA or AAPC credentials (e.g., CCS, CPC, RHIT, RHIA) required.
• Minimum 5 years of coding experience in healthcare settings.
• Deep understanding of ICD-10, CPT, HCPCS and official coding guidelines.
• Strong written and verbal communication skills.
• Ability to research and interpret complex coding guidelines and payer policies.
• Detail oriented with solid critical thinking and problem-solving abilities.

Responsibilities

• Serve as a liaison between coding teams and providers, delivering expert guidance.
• Collaborate with Edits and Denials to analyze trends and implement education.
• Partner with clinical leadership to ensure accurate documentation and coding compliance.
• Participate in quarterly meetings to provide coding education and respond to inquiries.
• Deliver comprehensive coding and documentation training for new providers.
• Provide annual education on code set updates to maintain compliance.
• Conduct annual provider audits to validate charges and identify revenue opportunities.
• Provide audits and follow-up for providers not meeting quality standards.
• Perform ad hoc audits in response to client requests.
• Educate coders and providers on audit findings and emerging trends.
• Assist with rebuttals for tri-annual audits as needed.

Skills

AHIMA/AAPC credentials

5+ years coding experience

ICD-10 CPT HCPCS knowledge

Communication skills

Research & interpretation

Attention to detail

Tools

X EHR

Y coding tools

Job description

UnitedHealth Group is seeking a Clinical Quality Analyst: OptumInsight SME to provide expert coding guidance, education, and support across health systems. This role analyzes trends, educates providers, and ensures accurate documentation and compliance with ICD-10, CPT, and HCPCS guidelines.

You’ll work remotely from anywhere in the U.S. and collaborate with Edits and Denials teams, leadership, and auditors to improve revenue integrity and quality.