Remote Outpatient Coding Compliance Auditor

UnitedHealthcare; United States; Remote; USD 73,000 - 130,000; Full time

Job summary

UnitedHealth Group, via Optum, seeks an Outpatient Coding Compliance Auditor for remote work across the U.S. You will audit outpatient facility coding (OPPS), verify ICD-10-CM and CPT/HCPCS accuracy, and ensure alignment with E/M guidelines and regulations.

Strong auditing skills and healthcare compliance background required. Responsibilities include validating coding accuracy, analyzing trends, documenting findings, and supporting QA activities.

Qualifications

• 5+ years of outpatient facility coding experience with OPPS and E/M guidance.
• Familiarity with NCCI/OCE edits and Medicare payment policies.
• Knowledge of ICD-10-CM and CPT CPT-4 coding rules.

Responsibilities

• Perform coding compliance and quality audits of outpatient facility coding.
• Analyze clinical documentation and validate E/M and procedure codes.
• Identify audit findings and perform root-cause analysis.
• Document results and communicate with stakeholders clearly.
• Support QA coding oversight and monitor industry regulatory updates.

Skills

Outpatient coding

Auditing

ICD-10-CM CPT coding

Regulatory knowledge

Communication

Education

CPC/CCS/COC certification

RHIA/RHIT/CPMA preferred

Tools

Microsoft Excel

Microsoft Teams

PowerPoint

Word

Outlook

Job description

UnitedHealth Group, via Optum, seeks an Outpatient Coding Compliance Auditor for remote work across the U.S. You will audit outpatient facility coding (OPPS), verify ICD-10-CM and CPT/HCPCS accuracy, and ensure alignment with E/M guidelines and regulations.

Strong auditing skills and healthcare compliance background required. Responsibilities include validating coding accuracy, analyzing trends, documenting findings, and supporting QA activities.