Remote Coding Quality Analyst: Healthcare Claims

Optum; Plymouth (MN); Remote; USD 68,770,000 - 123,213,000; Full time

Job summary

Optum is a global organization delivering care aided by technology to help millions live healthier lives. The Coding Quality Analyst researches and interprets healthcare correct coding using CMS, CPT/AMA guidance and payer policies, while documenting findings from medical record reviews.

This full-time role offers telecommuting from anywhere in the U.S. with shifts 6:00am–6:00pm, Monday–Friday, and occasional overtime as needed.

Qualifications

• High School Diploma or GED required.
• One or more coding credentials: RHIA, RHIT, CCS-P, CCS, CPC, or COC.
• 3+ years of medical coding experience (facility and physician).
• 3+ years reviewing, analyzing, and researching coding issues.

Responsibilities

• Conduct coding reviews of medical records against claims to determine accuracy.
• Process and/or review claims to meet production and quality goals.
• Provide coding guidance to the investigation team and stakeholders.
• Identify opportunities for cost savings and improved outcomes.

Skills

Microsoft Office

6:00am–6:00pm availability

Remote work

Education

High School Diploma/GED

HIM associate degree or higher

Tools

CMS coding rules

EMR systems

Job description

Optum is a global organization delivering care aided by technology to help millions live healthier lives. The Coding Quality Analyst researches and interprets healthcare correct coding using CMS, CPT/AMA guidance and payer policies, while documenting findings from medical record reviews.

This full-time role offers telecommuting from anywhere in the U.S. with shifts 6:00am–6:00pm, Monday–Friday, and occasional overtime as needed.