Quality Assurance Coding Auditor - Telecommute

    • Eden Prairie, MN

Position 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)

Primary Responsibilities:

  • Assists with execution of the daily activities of the Enterprise Quality Assurance program
  • Performs first level quality audits on vendor coding results
  • Performs first level quality audits on Care Delivery coding teams coding results
  • Provides support and assists all markets within Care Delivery on various coding initiatives, such as concurrent review, query compliance audits and retrospective coding quality reviews
  • Must 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
  • Perform all other related duties as assigned


Required Qualifications:

  • High school education or equivalent experience
  • Coding Certification required one or more of the following (the CPC-A or CCA are not acceptable) CPC, CCS, CCS-P, or RHIT
  • 4+ years recent experience ICD-9/10 coding, with strong high accuracy rate
  • 2+ years recent 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
  • Proficient knowledge of CMS-HCC model and guidelines
  • ICD-10-CM proficient
  • Must be able 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)
  • Must be able 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:

  • 4+ years recent experience ICD-9/10 coding, preferably in a Managed Care setting
  • EMR
  • Excel experience
  • Associate's degree or higher (may consider certificate program/completed college coursework with equivalent experience for degree)


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.

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.

Job Keywords: Coding Auditor, HCC Coding, Telecommute, Telecommuting, Telecommuter, Work at Home, Work from Home


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