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Coding Quality Assurance Analyst - QA - Telecommute in CO

Coding Quality Assurance Analyst - QA - Telecommute in CO-927918


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)

The Quality Assurance Analyst is responsible for performing quality reviews, coordination, development and monitoring of FFS medical coding activities and trends. Will serve as a resource in maintaining and distributing accurate, updated information on medical coding initiatives to the coding team and providers, as necessary. Assist with development of coder and provider audits, including QA review, reporting and individual/group education as necessary. Reviews and submits weekly submission files, works error files and submits delete files as necessary.

If you are located in Colorado, you will have the flexibility to telecommute* as you take on some tough challenges.

**Only Colorado based candidates will be considered for this role. This position will work remotely with the expectation of in person meetings and trainings. **

Primary Responsibilities:

  • Conducts physician chart audits to identify incorrect coding, prepares reports of findings and any compliance issues. Audits performed for both provider coding accuracy and documentation support as well as coding teammate accuracy
  • Reports coding patterns identified within the audit process to the Manager, and identifies corrective measures to compliance problems
  • Maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials
  • Interacts with physicians, coders and billing vendor, regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Interacts with coding teammates to deliver coding audit findings, discuss corrective measures and any necessary training required, and reports findings back to Coding Manager
  • Provides second-level review of billing performances to ensure compliance with legal and procedural policies to ensure adherence to regulations prohibiting unbundling and other questionable practices
  • Performs related work and projects as required

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 or equivalent
  • Certified Professional Coder (CPC) or equivalent
  • 3+ years of coding experience in hospital coding, various specialties, with an emphasis in primary care
  • Thorough understanding of E&M coding guidelines, including 2021 updates
  • Excellent understanding of medical terminology, disease process and anatomy and physiology
  • Excellent understanding of ICD-10-CM coding classification
  • Excellent understanding of CPT/HCPCS coding
  • Computer literate adept skill level on MS Office applications
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

  • 1+ years of experience in auditing teammate and healthcare provider documentation to identify correct ICD-10-CM, CPT, and/or HCPCS codes
  • Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) and Medicare Advantage reimbursement
  • Good organizational and communication skills
  • Task-oriented and ability to meet designated deadlines and productivity standards
  • Proven, well-developed interpersonal skills and excellent customer service skills

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)

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.

Colorado Residents Only: The hourly range for Colorado residents is $25.63 to $45.72. 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.

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

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 Quality Assurance Analyst, QA, Quality Assurance Analyst, QA Analyst, Coding, CPC, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, CO, Colorado

Job Medical CodingPrimary LocationUS-CO-GoldenOrganization Clinical PerformanceSchedule Full-timeNumber of Openings 1

Coding Quality Assurance Analyst - QA - Telecommute in CO

UnitedHealth Group EN
Golden, CO
Full Time

Published on 06/25/2021

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