Senior Coding SME - Remote Quality & Audit Lead

ISHE; Eden Prairie (MN); Hybrid; USD 73,000 - 130,000; Full time

Job summary

Optum360 is seeking a Coding SME to oversee facility-based and HIM coding operations across regions, leading quality metrics, audits, and standardizing workflows to ensure best practices in coding quality. You will engage in client meetings with Quality, CDI, and prebill teams while building strong client relationships.

The role supports remote work from anywhere in the U.S., collaborating with HIM, CDI, and Coding Operations to monitor daily activities, drive continuous improvement, and mentor

Qualifications

• 5+ years as a subject matter expert in corporate coding leadership for large multi-site healthcare organizations.
• 5+ years of experience as a coding reviewer auditing inpatient and/or outpatient accounts.
• 5+ years of experience collaborating with CDI and Quality leadership to improve reimbursement and accuracy.
• 5+ years of experience with computer assisted coding technologies and EMR coding workflows.
• Proficiency with Microsoft Excel and PowerPoint for data analysis and training.

Responsibilities

• Oversee Optum360 coding operations and drive standardization of processes.
• Lead initiatives to improve quality metrics, workflows, and audits.
• Manage client-facing meetings with Quality, CDI, and prebill teams.
• Ensure coding accuracy and remediation plans are followed.
• Mentor and develop HIM staff and cross-functional teams.

Skills

Coding leadership

Coding reviewer

CDI collaboration

EMR workflow

Audit & QA

Education

High School Diploma/GED

Tools

Microsoft Excel

PowerPoint

Job description

Optum360 is seeking a Coding SME to oversee facility-based and HIM coding operations across regions, leading quality metrics, audits, and standardizing workflows to ensure best practices in coding quality. You will engage in client meetings with Quality, CDI, and prebill teams while building strong client relationships.

The role supports remote work from anywhere in the U.S., collaborating with HIM, CDI, and Coding Operations to monitor daily activities, drive continuous improvement, and mentor