Quality Assurance Auditor - Telecommute

UnitedHealth Group

Atlanta Georgia

United States

Information Technology
(No Timezone Provided)

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.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. 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
  • 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
  • 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)
  • 4+ years recent experience ICD-9/10 coding, preferably in a Managed Care setting, with solid attention to detail and 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
  • 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
  • Excellent organizational, problem solving, and critical thinking skills
  • Excellent verbal/written communication and interpersonal skills

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado Residents Only: The hourly range for Colorado residents is $20.77 to $36.88. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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.

Job Keywords: Quality Assurance Auditor, Coding, Telecommute, Work from Home, Optum, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

Quality Assurance Auditor - Telecommute

UnitedHealth Group

Atlanta Georgia

United States

Information Technology

(No Timezone Provided)

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.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. 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
  • 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
  • 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)
  • 4+ years recent experience ICD-9/10 coding, preferably in a Managed Care setting, with solid attention to detail and 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
  • 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
  • Excellent organizational, problem solving, and critical thinking skills
  • Excellent verbal/written communication and interpersonal skills

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado Residents Only: The hourly range for Colorado residents is $20.77 to $36.88. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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.

Job Keywords: Quality Assurance Auditor, Coding, Telecommute, Work from Home, Optum, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote