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Coding Quality Assurance Auditor - Telecommute in CST or MTN Time Zones

Company: UnitedHealth Group
Location: Indianapolis
Posted on: June 25, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) - This role will provide coding quality auditing services to ensure compliance with Optum and CMS coding guidelines and accuracy of coding data reported. - Will review provider's documentation to identify query opportunities. Must maintain compliance with Optum Coding Guidelines/policies. The minimum productivity goal is set by project, with minimum 96% coding accuracy rate required. If you are located in CST or MTN Time zones, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities:

  • Assists with execution of the daily activities of the Enterprise Quality Assurance program
  • Performs first level quality audits on vendor coding results
  • Identifies provider query opportunity, creates and sends compliant query to rendering provider
  • Provides support and assists on various coding initiatives, such as concurrent review, query compliance audits and retrospective coding quality reviews
  • Be able to work with multiple coding tools and EMR systems
  • Ensure that Optum Coding Guidelines are consistently applied in all processes
  • Identifies issues and trends in coding and documentation that affect coding accuracy
  • Provides input and valuable feedback on audit results
  • Recommends process improvement
  • Perform all other related duties as assigned 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:
    • Associate degree or equivalent experience
    • Coding Certification (CPC, COC, CIC, CCS, CCS-P, or RHIT; the CPC-A or CCA designation is not acceptable)
    • 3+ years of experience in ICD-9/10 coding, preferably in a Managed Care setting, with solid attention to detail and high accuracy rate
    • 2+ years of Medicare Risk Adjustment experience (HCC coding)
    • 1+ years recent experience in a coding auditor role - auditing the work of other coders and providing feedback/coaching
    • Expertise in compliant querying practice and guidelines
    • Proficient knowledge of CMS-HCC model and guidelines
    • ICD-10-CM proficient
    • Ability to work during normal business hours, Monday-Friday 8am-5pm CST (flexibility to start 8-hour shift earlier or later after successful completion of training)
    • Ability to continuously meet the requirements for a telecommuter, i.e., live in a location that can receive a UnitedHealth Group approved high speed internet connection, have a secure designated office space to maintain PHI, meet or exceed all performance expectations Preferred Qualifications:
      • Bachelor's degree
      • CRC (Certified Risk Coder) in addition to coding certification
      • 2+ years of coding experience working in a provider's office
      • Inpatient coding experience
      • Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
      • Knowledge of HEDIS/STARS
      • Demonstrated excellent organizational, problem solving, and critical thinking skills
      • Proven excellent verbal/written communication and interpersonal skills
      • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm) OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians. *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Colorado, Connecticut or Nevada Residents Only: The salary/hourly range for Colorado residents is $21.68 to $38.56. The salary/hourly range for Connecticut/Nevada residents is $23.94 to $42.40. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. - OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Keywords: UnitedHealth Group, Indianapolis , Coding Quality Assurance Auditor - Telecommute in CST or MTN Time Zones, Accounting, Auditing , Indianapolis, Indiana

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