Remote Coding Quality & Compliance Analyst

Sacbar; Eden Prairie (MN); Hybrid; USD 50,000 - 89,000; Full time

Job summary

Optum360 is seeking a qualified professional to lead outpatient facility coding and auditing efforts across domestic and global teams. The role emphasizes regulatory compliance, quality improvement, and collaboration with CMS and other regulators.

Telecommuting is supported from anywhere in the U.S., with a pay range that reflects experience and local markets. The candidate will drive coding quality, develop training materials, and work with stakeholders to mitigate risks while ensuring

Qualifications

• 3+ years of Outpatient Facility coding and auditing experience.
• 1+ years of experience working collaboratively with quality leadership in partnership to improve reimbursement and coding accuracy.
• 1+ years of experience with computer assisted coding technologies and EMR (Electronic Medical Record) coding workflow.
• Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint, and SharePoint.

Responsibilities

• Maintain and demonstrate expert knowledge of coding, coding operations, coding review of all coding staff (domestic and global) and best demonstrated coding practices; drives the integration of Optum360 Coding related business objectives within the client environment
• Serve as the expert of applicable Federal, State, and local laws and regulations, Optum360's organizational integrity program, standards of conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
• Communicate the potential impact of compliance issues and risks on our business, operations, and consumers to applicable stakeholders.
• Collaborate with applicable regulators (e.g., CMS) to prevent or address potential compliance issues within our organization.
• Conduct internal monitoring/auditing to identify process gaps and help the business address organizational risks.
• Collaborate with internal stakeholders across organization lines to help identify root causes of compliance issues, and support appropriate action to mitigate risk.

Education

High School Diploma/GED

AAPC or AHIMA certification (CCS, CPC, RHIT or RHIA)

Tools

Microsoft Excel

Word

PowerPoint

SharePoint

Job description

Optum360 is seeking a qualified professional to lead outpatient facility coding and auditing efforts across domestic and global teams. The role emphasizes regulatory compliance, quality improvement, and collaboration with CMS and other regulators.

Telecommuting is supported from anywhere in the U.S., with a pay range that reflects experience and local markets. The candidate will drive coding quality, develop training materials, and work with stakeholders to mitigate risks while ensuring