Description

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

The LPS (Learning & Performance Solutions) QA Inpatient Coding Auditor will provide expert coding audit services across various acute hospital organizations for inpatient services. Review medical record documentation and related coding of inpatient encounters utilizing the ICD-10-CM/PCS classification and CMS MS-DRG system. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, official coding guidelines and industry standards. This individual will provide education to coders on audit results, utilize their expertise to research and respond to complex inpatient coding questions, and evaluate audit results to recommend corrective actions. The individual will have the expertise to respond to client requests to conduct ad hoc coding audits.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Perform coding quality audits in support of Optum Insight's Learning & Performance Program and client expectations
• Analyze and interpret documentation from inpatient medical records
• Clearly document audit findings, cite appropriate coding guideline references and calculate error rates
• Provide feedback and education as appropriate depending on findings
• Articulate audit findings appropriate for audience. Prepare written audit reports as needed summarizing audit findings and any corrective action necessary to mitigate risk
• Serve as an expert coding resource to client organizations and provide expert coding guidance
• Conduct ad hoc coding audits as requested
• Stay up-to-date on relevant official coding guidelines, Coding Clinic®, and other industry official guidance
• Research, develop and present coding education to coders and management as requested

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:

• Coding Certification from AHIMA or AAPC such as Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Specialist (CCS); or Certified Inpatient Coder (CIC)
• 3+ years of acute inpatient hospital coding experience using ICD-10-CM/PCS classification in an academic medical center or 2+ years of inpatient coding audit experience
• 1+ years of current experience / knowledge of acute hospital official coding guidelines, the ICD-10-CM/PCS classification system, MS/APR-DRG systems, and American Hospital Association (AHA) Coding Clinic® for ICD-10-CM/PCS
• 1+ years of experience with common electronic health records (EHR), encoder/grouper and computer assisted coding applications
• Experience with Microsoft Office applications, particularly Excel, Word, Outlook, and Teams

Preferred Qualifications:

• 6+ years of inpatient coding audit experience
• Experience using the Optum computer assisted coding (eCAC) product, and/or other common CAC/encoder software applications
• Experience using electronic health record (EHR) applications such as Cerner and Epic
• Proven current knowledge and current or past experience coding acute hospital outpatient accounts such as outpatient surgery and emergency room (ED) encounters using CPT®

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.