Remote Outpatient Coding Compliance Auditor — Impactful

UnitedHealthcare At Home; Montgomery (AL); Remote; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group's Optum unit seeks an Outpatient Coding Compliance Auditor to perform audits of outpatient facility coding, ensuring accuracy of ICD-10-CM, CPT/HCPCS, and E/M levels, and to communicate findings to stakeholders. The role supports compliance with laws and billing standards while contributing to QA oversight.

Responsibilities include identifying findings, calculating error rates, root cause analysis, documenting results, and developing targeted education.

Qualifications

• Certified Professional Coder (CPC) or CCS or COC certification required or preferred.
• 5+ years outpatient facility coding experience with Medicare/OPPS knowledge.
• 5+ years outpatient facility audit experience including surgery, observation and ED.

Responsibilities

• Perform coding compliance and quality audits for outpatient facility coding.
• Analyze clinical documentation and validate accuracy of E/M services and modifiers.
• Identify findings, compute error rates, and perform root-cause analysis.
• Document audit findings and present results to stakeholders.
• Develop and present targeted education based on audit findings.
• Support QA coding oversight and ensure consistency with standards.

Skills

Outpatient coding

Audits

Communication skills

Education

RHIA/RHIT/CPMA certification preferred

Tools

Microsoft Excel

Microsoft Office (Teams/PowerPoint/Word/Outlook)

Job description

UnitedHealth Group's Optum unit seeks an Outpatient Coding Compliance Auditor to perform audits of outpatient facility coding, ensuring accuracy of ICD-10-CM, CPT/HCPCS, and E/M levels, and to communicate findings to stakeholders. The role supports compliance with laws and billing standards while contributing to QA oversight.

Responsibilities include identifying findings, calculating error rates, root cause analysis, documenting results, and developing targeted education.