Remote Coding Quality Analyst: Audit & Fraud

NHSHP; Plymouth (MN); Hybrid; USD 33,000 - 59,000; Full time

Benefits offered by this job

Telecommuting

On-the-job training

Job summary

UnitedHealth Group’s Optum division seeks a Coding Quality Analyst. This full-time role is 40 hours weekly, Monday–Friday, with 8-hour shifts 8am–5pm CST and occasional overtime.

Training is provided, and you can telecommute from anywhere in the U.S. Responsibilities include reviewing records for suspicious or fraudulent activity, documenting decisions, and presenting findings to internal and external groups.

Qualifications

• High School Diploma or GED required.
• Active coding certification: AHIMA CCS/CCS-P or RHIT or AAPC CPC.
• Minimum 2+ years CPT coding experience.
• Minimum 2+ years medical record auditing experience.

Responsibilities

• Reviews records identified as suspicious or potentially fraudulent using current CPT/ICD-9/ICD-10/HCPCS guidelines.
• Documents decisions through notes in appropriate company systems.
• Discusses and presents decisions to internal/external individuals or groups.
• Coordinates with team on trends related to billing issues/coding trends.

Skills

CPT coding experience

Medical record auditing

Education

High School Diploma/GED

Job description

UnitedHealth Group’s Optum division seeks a Coding Quality Analyst. This full-time role is 40 hours weekly, Monday–Friday, with 8-hour shifts 8am–5pm CST and occasional overtime.

Training is provided, and you can telecommute from anywhere in the U.S. Responsibilities include reviewing records for suspicious or fraudulent activity, documenting decisions, and presenting findings to internal and external groups.