Remote Outpatient Coding Compliance Auditor

UnitedHealth Group; Montgomery (AL); Remote; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Equity stock purchase plan

401k contribution

Job summary

Optum, a UnitedHealth Group company, seeks an Outpatient Coding Compliance Auditor to audit OPPS coding, ICD-10-CM, CPT/HCPCS, and E/M levels, ensuring documentation aligns with guidelines. This role supports the Compliance Program and communicates findings to stakeholders.

You can work remotely from anywhere in the U.S. The position requires CPC/CCS/COC and 5+ years of outpatient coding and audit experience, with RHIA/RHIT/CPMA a plus.

Qualifications

• CPC/CCS/COC certification.
• 5+ years outpatient facility coding experience.
• 5+ years outpatient facility audit experience, Medicare knowledge.

Responsibilities

• Perform coding compliance and quality audits for outpatient facility coding.
• Analyze clinical documentation to validate ICD-10-CM and CPT coding.
• Assess E/M levels and modifiers per ACEP or client guidelines.
• Identify findings, calculate error rates, and determine root causes.
• Document audit results and communicate to stakeholders clearly.
• Support QA oversight of coding audits and vendor reviews.

Skills

CPC/CCS/COC

Medicare regulations

Regulatory awareness

Education

RHIA

RHIT

CPMA

Tools

Microsoft Excel

Teams

PowerPoint

Word

Outlook

Job description

Optum, a UnitedHealth Group company, seeks an Outpatient Coding Compliance Auditor to audit OPPS coding, ICD-10-CM, CPT/HCPCS, and E/M levels, ensuring documentation aligns with guidelines. This role supports the Compliance Program and communicates findings to stakeholders.

You can work remotely from anywhere in the U.S. The position requires CPC/CCS/COC and 5+ years of outpatient coding and audit experience, with RHIA/RHIT/CPMA a plus.