Remote Medical Coding Auditor - Impact & Compliance Expert

Reliant Medical Group; Minneapolis (MN); Remote; USD 33,000 - 59,000; Full time

Job summary

UnitedHealth Group is seeking a Medical Coding Auditor to review CPT/HCPCS codes and modifiers on telecommuting claims. You will determine accuracy of coding, provide detailed narratives, and ensure compliance with state and federal policies while identifying aberrant patterns for review.

The role requires AHIMA (CCA/CCS/CCS-P) or AAPC (CPC/CPC-I) certification, 2+ years of coding and medical record review experience, and the ability to work in a metric-driven, team-based environment.

Qualifications

• AHIMA or AAPC certification required (CCA/CCS/CCS-P or CPC/CPC-I).
• Minimum 2 years coding experience with AHIMA or AAPC credentials.
• 2+ years CPT/HCPCS/modifier coding experience and medical record reviews.
• 1+ year in a metric-driven team environment with daily production standards.

Responsibilities

• Performs clinical review of CPT/HCPCS and modifiers on claims in a telecommuting environment.
• Determines accuracy of medical coding/billing and payment recommendations.
• Provides detailed clinical narratives on case outcomes.
• Ensures adherence to state and federal compliance and contract terms.
• Identifies aberrant billing patterns and flags providers for review.

Skills

AHIMA/AAPC Coding

CPT/HCPCS Proficiency

Medical Record Review

Team Collaboration

Regulatory Compliance

Tools

COSMOS

Facets

CPW

NICE

UNETProficient

Microsoft Office

Adobe Acrobat

Job description

UnitedHealth Group is seeking a Medical Coding Auditor to review CPT/HCPCS codes and modifiers on telecommuting claims. You will determine accuracy of coding, provide detailed narratives, and ensure compliance with state and federal policies while identifying aberrant patterns for review.

The role requires AHIMA (CCA/CCS/CCS-P) or AAPC (CPC/CPC-I) certification, 2+ years of coding and medical record review experience, and the ability to work in a metric-driven, team-based environment.