Remote Coding Quality Analyst – Health Data & Compliance

UnitedHealth Group; Plymouth (MN); Remoto; USD 33.000 - 59.000; Tempo pieno

Descrizione del lavoro

UnitedHealth Group is seeking a Coding Quality Analyst to join our Clinical Professional Coding team. You will review professional claims and medical records to ensure coding accuracy and support audits, while driving process improvements for external clients.

This role offers telecommuting from anywhere in the U.S., with emphasis on compliance, documentation quality, and collaboration across departments. Ideal candidates hold CPC/COC/CPMA/CCS or nursing licensure and have 2+ years of

Competenze

• High School Diploma or GED required.
• Certified coder (CPC, COC, CPMA, CCS) or Nursing Licensure.
• 2+ years multi-specialty coding experience including Evaluation and Management.
• 2+ years of experience with Microsoft Office applications.

Mansioni

• Perform clinical review of professional claims and supporting medical records to determine coding support and reimbursement compliance.
• Maintain departmental productivity, quality, and accuracy standards.
• Develop and communicate clear, concise clinical rationales for review determinations.
• Analyze data to identify discrepancies and reimbursement opportunities.
• Investigate and resolve claim review findings for various clients.
• Ensure compliance with state and federal regulations and internal guidelines.
• Document review findings and supporting rationale in applicable systems.
• Attend meetings and collaborate with internal stakeholders to drive continuous improvement.

Conoscenze

Microsoft Office

Analytical thinking

Problem solving

Formazione

High School Diploma/GED

Strumenti

CAP

OPRS

FACETS

Encoder

EPIC

Descrizione del lavoro

UnitedHealth Group is seeking a Coding Quality Analyst to join our Clinical Professional Coding team. You will review professional claims and medical records to ensure coding accuracy and support audits, while driving process improvements for external clients.

This role offers telecommuting from anywhere in the U.S., with emphasis on compliance, documentation quality, and collaboration across departments. Ideal candidates hold CPC/COC/CPMA/CCS or nursing licensure and have 2+ years of