Remote Outpatient Coding Compliance Auditor

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

Benefits offered by this job

Remote work from anywhere in the U.S.

Comprehensive benefits

Job summary

Optum, a part of UnitedHealth Group, is seeking an Outpatient Coding Compliance Auditor to perform audits of outpatient facility coding, ensuring ICD-10-CM, CPT, modifiers, and E/M levels align with documentation and regulations. This role supports the Compliance Program and QA coding oversight from a remote U.S.

location. The position requires CPC/CCS/COC certification and 5+ years in outpatient facility coding/auditing, with strong communication and analytical skills.

Qualifications

• CPC or CCS or COC certification required.
• 5+ years of outpatient facility coding experience.
• Experience with ICD-10-CM and CPT coding.
• Knowledge of NCCI/OCE edits for outpatient services.
• ACEP Facility or equivalent E/M guidelines for outpatient coding.
• 5+ years of outpatient facility audit experience including surgery, observation, and ED.

Responsibilities

• Perform coding compliance and quality audits to support the Compliance Program.
• Interpret clinical documentation from medical records.
• Validate outpatient facility coding for E/M services, procedures, and modifiers.
• Identify audit findings, calculate error rates, and perform root cause analysis.
• Assess corrective actions and provide follow-up validation.
• Document audit findings clearly for diverse audiences.
• Prepare audit analyses and reports on risk and trends.
• Audit vendor coders and offshore staff as needed.
• Monitor industry trends and regulatory updates affecting coding and billing.
• Develop and present targeted education based on audit findings.

Skills

Strong communication

Time management

Attention to detail

Independent auditing

Education

RHIA/RHIT/CPMA a plus

Tools

Excel

Teams

PowerPoint

Word

Outlook

Job description

Optum, a part of UnitedHealth Group, is seeking an Outpatient Coding Compliance Auditor to perform audits of outpatient facility coding, ensuring ICD-10-CM, CPT, modifiers, and E/M levels align with documentation and regulations. This role supports the Compliance Program and QA coding oversight from a remote U.S.

location. The position requires CPC/CCS/COC certification and 5+ years in outpatient facility coding/auditing, with strong communication and analytical skills.