Coding Quality Analyst - National Remote
Company: UnitedHealth Group
Location: Hartford
Posted on: September 20, 2023
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Job Description:
You'll enjoy the flexibility to telecommute* from anywhere
within the U.S. as you take on some tough challenges.
Opportunities at Change Healthcare, part of the Optum family of
businesses. We are transforming the health care system through
innovative technology and analytics. Find opportunities to make a
difference in a variety of career areas as we all play a role in
accelerating health care transformation. Help us deliver
cutting-edge solutions for patients, hospitals and insurance
companies, resulting in healthier communities. Use your talents to
improve the health outcomes of millions of people and discover the
meaning behind: Caring. Connecting. Growing together.------
The Payment Integrity Coding Analyst researches and interprets
healthcare correct coding using regulatory requirements and
guidance related to CMS, CPT/AMA and other major payer policies. -
They also use internal business rules to prepare written
documentation of findings through medical record review. The Coding
Analyst possesses an overall understanding of all coding
principles, including facility and physician coding and provides
health care payers with a total claim management solution. -
Typically, 90% of a Coding Analyst's time is spent performing
coding and documentation review and 10% spent performing other
tasks as assigned.
This position is full-time, Monday - Friday. Employees are required
to have flexibility to work any of our 8-hour shift schedules
during our normal business hours of 6:00am - 6:00pm. It may be
necessary, given the business need, to work occasional
overtime.
*All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy.
Primary Responsibilities: -
Conduct coding reviews of medical records and supporting
documentation against submitted claims, for individual provider and
facility claims, to determine coding and billing accurate for all
products.
Process and/or review claims in a timely manner utilizing client
specific coding and billing requirements that meet or exceed
production and quality goals.
Participate in process improvement activities and encourage
ownership of and group participation in improvement
initiatives.
Analyze medical documents to evaluate potential issues of fraud and
abuse.
Document coding review findings within investigative case tracking
system and maintains thorough and objective documentation of
findings.
Serve as a coding resource and provide coding expertise and
guidance to entire investigation team.
Identify and recommend opportunities for cost savings and improving
outcomes.
Coordinate activities with varying levels of leadership including
the investigative team, legal counsel, internal and external
customers, law enforcement and regulatory agencies, and medical
professionals through effective verbal and written communications
as needed.
Research and interpret correct coding guidelines and internal
business rules to respond to customer inquiries, and monitors CMS
and major payer coding and reimbursement policies.
Must be able to take and pass Coding Assessment.
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 higher)
3+ years of experience in medical coding with primary focus in
facility and physician coding.
3+ years of experience in reviewing, analyzing, and researching
coding issues.
Must have one or more of the following coding credentials: - RHIA,
RHIT, CCS-P, CCS or CPC
Proficiency in Microsoft Office skills including Outlook, Excel,
and Word (Open/Edit/Create/Save/Send)
Ability to work full-time, Monday - Friday between 6:00am - 6:00pm
including the flexibility to work occasional overtime given the
business need
Preferred Qualification:
Associate Degree (or higher) OR equivalent in Health Information
Management
Experience with reimbursement policy and/or claims
Telecommuting Requirements:
Soft Skills:
Self-starting and independent, able to stay focused while working
remotely.
Ability to establish good customer relationships with trust and
respect.
Do you have at least one previous position that required a high
level of attention to written communication?
California, Colorado, Connecticut, Nevada, New Jersey, New York,
Washington or Rhode Island Residents Only: The salary range for
California / Colorado / Connecticut / Nevada / New Jersey / New
York / Washington / Rhode Island residents is $22.45 - $43.89.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.
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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.
#RPO #YELLOW
Keywords: UnitedHealth Group, Hartford , Coding Quality Analyst - National Remote, Professions , Hartford, Connecticut
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