All roles

Coding Quality Analyst - National Remote

Remote · USA Full-time New today

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The OptumHealth Behavioral Solutions (OHBS) PNI Coding Quality Analyst is responsible for coding and auditing services specific to administrative fraud, waste and abuse cases. This includes the analysis, documentation, explanation and translation of medical and behavioral diagnosis and procedures. The Medical Coder/Analyst will support the OHBS PNI in research, issues and inquires that relate to their reviews and policies on Medical Coding/Auditing. This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime. We offer 2 weeks of on-the-job training followed by a 90-day ramp up period. The hours of training will be based on your schedule or will be discussed on your first day of employment. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: • Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent, utilizing most current reference materials to include, but not limited to: Current Procedural Terminology (CPT), Internal Classification of Disease (ICD-9/ICD 10) and Healthcare Common Procedure Coding System (HCPCs) guidelines • Documents Decisions on reviews through notations and enters notes in appropriate company systems • Ability to discuss and present on decisions made to appropriate internal and external individuals/groups • Coordinate with team members to understand trends and schemes related to billing issues/coding trends You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • High School Diploma / GED • Certified Coder AHIMA (CCS, CCS-P, RHIT) or AAPC Certified Coder (CPC) • Must be 18 years of age OR older • 3+ years of coding experience in CPT medical coding / auditing or coding review for quality assurance • Ability to work any of our 8-hour shift schedules during our normal business hours of 6:00am - 6:00pm, including the flexibility to work occasional overtime, based on the business need Preferred Qualifications: • Behavioral Health experience • Knowledge of CMS 1500 and UB04 data elements • Encoder Pro familiarity Telecommuting Requirements: • Ability to keep all company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information privacy • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Soft Skills: • Excellent oral and written communication skills • Excellent organizational / time management skills and ability to work independently or as a team • Problem solving skills • Ability to meet production unit standards while engaging in multiple priorities • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $23.22 to $45.43 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO Apply Job!

Related roles

Quality/Utilization Program Specialist (Healthcare/Dental Experience Required)

Remote · USA Full-time

Distinguished Engineer - Workday Financials (REMOTE)

Remote · USA Full-time

Educator | Disney Springs (Part-Time Contract)

Remote · USA Full-time

Sr Project Manager, Mobile & Web

Remote · USA Full-time

Disney Remote Part Time Jobs $26/Hr

Remote · USA Full-time

American Express Remote Data Entry Positions

Remote · USA Full-time

Executive Assistant (Remote Part-time or Full-time)

Remote · USA Full-time

Organizational Change Manager (SAP Enable Now)

Remote · USA Full-time

Customer Service Insurance- Sales (Signing Bonus)

Remote · USA Full-time

Global Strategic Account and Operations Manager

Remote · USA Full-time

Scoring Assistant - English Language Arts & Reading 7-12

Remote · USA Full-time

Experienced Full Stack Senior Accountant – Financial Reporting and Analysis

Remote · USA Full-time

Experienced Part-Time Scheduling Coordinator - Hybrid Remote Applied Behavior Analysis Specialist

Remote · USA Full-time

URGENT NEED - SAP Test Lead _ REMOTE

Remote · USA Full-time

Project Manager - Sector Espacio

Remote · USA Full-time

SA FIFO Team Leaders & Supervisors – Cleaning, Catering, Bar & Administration

Remote · USA Full-time

Experienced Customer Service Representative - Remote Work Opportunity in Aviation Industry with blithequark

Remote · USA Full-time

Chief of Staff, Strategic Initiatives

Remote · USA Full-time

Cisco Systems, Inc. Maynard, MA Lobby Ambassador

Remote · USA Full-time

Sr. Underwriting Counsel (Remote/Hybrid)

Remote · USA Full-time