Remote Coding Quality & Compliance Analyst

Optum; Eden Prairie (MN); Remote; USD 40,000 - 72,000; Full time

Job summary

Optum is seeking a Coding Support Subject Matter Expert to guide coding teams and providers across health systems, ensuring accurate ICD-10, CPT, HCPCS coding and payer compliance. Remote work within the U.S. is supported.

You will analyze coding trends, train providers, perform audits, and collaborate with Edits and Denials teams to improve revenue integrity.

A minimum of 5 years of healthcare coding experience and AHIMA or AAPC credentials are required.

Qualifications

• AHIMA or AAPC credentials required.
• 5+ years of healthcare coding experience (inpatient, outpatient, or professional coding).
• Solid knowledge of ICD-10, CPT, HCPCS and official coding guidelines.

Responsibilities

• Serve as liaison between coding teams and providers, delivering expert guidance.
• Collaborate with Edits and Denials to analyze trends and implement education or system edits.
• Partner with clinical leadership to ensure accurate documentation and coding compliance for new services.
• Present at quarterly meetings to provide coding education and respond to inquiries.
• Deliver comprehensive coding training for new providers.
• Provide annual provider education on code set updates to maintain compliance.
• Conduct annual provider audits to validate charges and documentation.
• Offer targeted education and follow-up audits for underperforming providers.
• Perform ad hoc audits upon client requests or identified concerns.
• Educate coders and providers on audit findings to promote improvement.
• Assist with rebuttals for tri-annual audits if needed.

Skills

ICD-10 knowledge

CPT/HCPCS knowledge

Communication skills

Policy interpretation

Detail oriented

Remote work adaptability

Education

AHIMA or AAPC credentials

Tools

Coding guidelines

Job description

Optum is seeking a Coding Support Subject Matter Expert to guide coding teams and providers across health systems, ensuring accurate ICD-10, CPT, HCPCS coding and payer compliance. Remote work within the U.S. is supported.

You will analyze coding trends, train providers, perform audits, and collaborate with Edits and Denials teams to improve revenue integrity.

A minimum of 5 years of healthcare coding experience and AHIMA or AAPC credentials are required.