Coding Quality Analyst - National Remote
Company: UnitedHealth Group
Posted on: November 18, 2023
You'll enjoy the flexibility to telecommute* from anywhere
within the U.S. as you take on some tough challenges.
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 -Coding Quality Analyst -is responsible for Investigating Optum
Waste and Error stopped claims by gathering information,
researching state and federal guidelines, and following internal
procedure to determine the viability of the claim for further
review in a production environment. -
This position is full-time (40 hours/week) Monday - Friday.
Employees are required to have flexibility to work any of our
8-hour shift schedules during our normal business hours. Will pick
schedule to work with manager after training. It may be necessary,
given the business need, to work occasional overtime. -
We offer weeks of paid training. The hours of the training will be
based on schedule or will be discussed on your first day of
*All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy.
- Perform clinical review of professional claims vs. medical
records to determine if the claim is supported or
- Maintain standards for productivity and accuracy. - Standards
are defined by the department.
- Provide clear and concise clinical logic to the providers when
- Attend and provide feedback during monthly meetings with
assigned internal customer department.
- Provide continuous feedback on how to improve the department
relationships with internal team members and departments.
- Keep up required Coding Certificate and/or Nursing
- Complete compliance hours as required by the department.
The pace is fast, so your ability to multi-task is essential. You
should also enjoy working with people and have the communication
skills necessary to build strong relationships with our patients.
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
- High School Diploma / GED
- 2+ years of experience with claims auditing and researching
- Working knowledge of the healthcare insurance and/or managed
- Previous experience in claim processing, healthcare provider
information or healthcare billing practices
- Working knowledge of medical terminology and claim
- Knowledge of claims processing systems and
- Proficient with personal computers, including Microsoft Suite
of products. (Open, create, edit, send)
- Required Coding Certificate (any listed below or equivalent):
Must have one of the following: -
- Certified Professional Coder (CPC)
- Certified Professional Medical Auditor (CPMA)
- Certified Coding Specialist (CCS)
- Medical record coding experience with experience in Evaluation
and Management Services in the outpatient/ medical office
- Must be 18 years of age OR older
- Ability to work any of our 8-hour shift schedules during our
normal business hours. Will pick schedule to work with manager
after training. It may be necessary, given the business need, to
work occasional overtime. -
- 1+ years of experience in a coding role
- Experience with Microsoft Office
- Previous presentation or policy documentation
- Knowledge of Medicaid/Medicare Reimbursement Methodologies
- Ability to keep all company sensitive documents secure (if
- Required to have a dedicated work area established that is
separated from other living areas and provides information
- Must live in a location that can receive a UnitedHealth Group
approved high-speed internet connection or leverage an existing
high-speed internet service.
- Strong customer service skills.
- Ability to work in a team.
- Strong analytical and problem-solving skills.
- Strong written and verbal communications skills.
California, Colorado, Connecticut, Nevada, New Jersey, New York,
Washington or Rhode Island Residents Only: The hourly range for
California / Colorado / Connecticut / Nevada / New York / New
Jersey / Washington / Rhode Island residents is $22.45 - $43.89 per
hour. 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.
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.
Keywords: UnitedHealth Group, Miami , Coding Quality Analyst - National Remote, Professions , Miami, Florida
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