Remote Coding Quality Analyst – Health Billing

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

Job summary

Optum is a global health services company focused on improving health outcomes through technology. The Coding Quality Analyst role is full time, 40 hours per week, Monday to Friday, with flexible 8-hour shifts during 8am–5pm CST and occasional overtime.

Telecommuting is allowed from anywhere in the U.S. Primary responsibilities include reviewing records for accuracy and potential fraud, documenting decisions, presenting findings, and collaborating with team members to identify billing and coding

Qualifications

• High School Diploma or GED required.
• Active and unrestricted coding certification from AHIMA (CCS/CCS-P or RHIT) or AAPC (CPC) required.
• 2+ years of CPT medical coding experience.
• 2+ years of medical record auditing experience.
• Must be 18 years of age or older.

Responsibilities

• Conducts reviews on records identified as suspicious or potentially fraudulent using CPT, ICD-9/ICD-10, and HCPCS guidelines.
• Documents decisions on reviews and enters notes in company systems.
• Ability to discuss and present decisions to internal/external stakeholders.
• Coordinate with team to understand trends and schemes related to billing issues/coding trends.

Skills

CPT medical coding

Medical record auditing

Education

High School Diploma/GED

AHIMA CCS/CCS-P or RHIT

AAPC CPC

Job description

Optum is a global health services company focused on improving health outcomes through technology. The Coding Quality Analyst role is full time, 40 hours per week, Monday to Friday, with flexible 8-hour shifts during 8am–5pm CST and occasional overtime.

Telecommuting is allowed from anywhere in the U.S. Primary responsibilities include reviewing records for accuracy and potential fraud, documenting decisions, presenting findings, and collaborating with team members to identify billing and coding