Remote Coding Quality Analyst — Audits & Compliance

Colorado Psychiatric; Plymouth, Northern (MN, KY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Optum is seeking a Coding Quality Analyst for a full-time role, with telecommuting options within the United States. The position involves reviewing medical records for coding accuracy, documenting decisions, and presenting findings to stakeholders.

Requirements include AHIMA or AAPC certification, CPT coding experience, and auditing background. Employees receive on-the-job training and may work flexible 8-hour shifts during CST business hours, with occasional overtime as needed.

Qualifications

• High School Diploma or GED is required.
• Active and unrestricted coding certification from AHIMA (CCS, CCS-P or RHIT) or AAPC (CPC) is required.
• 2+ years of coding experience in CPT medical coding is required.
• 2+ years of medical record auditing experience is required.
• Ability to work full time 40 hours per week within standard hours; overtime may be needed.

Responsibilities

• Conduct reviews on records identified as suspicious or potentially fraudulent using CPT, ICD-9/ICD-10, HCPCS guidelines.
• Document decisions in notes and company systems.
• Discuss and present decisions to internal/external stakeholders as needed.
• Coordinate with team to identify billing trends and coding issues.

Skills

CPT coding

Medical record auditing

Communication skills

Education

High School Diploma/GED

AHIMA CCS/CCS-P or RHIT or AAPC CPC certification

Job description

Optum is seeking a Coding Quality Analyst for a full-time role, with telecommuting options within the United States. The position involves reviewing medical records for coding accuracy, documenting decisions, and presenting findings to stakeholders.

Requirements include AHIMA or AAPC certification, CPT coding experience, and auditing background. Employees receive on-the-job training and may work flexible 8-hour shifts during CST business hours, with occasional overtime as needed.