Coding Quality Analyst - National Remote - Healthcare Risk Adjustment and Compliance Expert

Join the UnitedHealth Group Team as a Coding Quality Analyst - National Remote

Embark on a rewarding career journey with UnitedHealth Group, a leading provider of health care services and solutions. We are seeking a highly skilled and detail-oriented Coding Quality Analyst to join our team remotely. As a Coding Quality Analyst, you will play a critical role in ensuring the accuracy and compliance of coding practices across our organization. This is a unique opportunity to work with a premier provider of risk adjustment services, software, and solutions that are fueling innovation in the health care industry.

About UnitedHealth Group

UnitedHealth Group is a global, remote/hybrid-friendly team dedicated to bridging health care gaps with a strong sense of social responsibility. Our culture is rooted in innovation, encouraging our team to stay curious and engaged. By joining us, you become part of a team that is enriching lives, including those of our team members through Caring. Connecting. Growing together.

Job Summary

As a Coding Quality Analyst, you will serve as a resource to others while performing peer-to-peer overreads on a daily basis. This role will have assignments of projects where deadlines and scope shift frequently. You will oversee the quality of main-line coding practices under the direction of your respective manager. This is a full-time (40 hours / week) Monday - Friday position, with flexible scheduling and occasional overtime as needed.

Key Responsibilities

• Accurately read and analyze CMS as well as client-specific coding guidelines
• Perform peer-to-peer and vendor over-reads
• Review medical records previously coded by peers to determine and ensure accuracy, completeness, specificity, and appropriateness of diagnosis codes based on documentation in accordance with established CMS and client-specific guidelines for MRA and ACA coding
• Prepare and present written feedback to coding staff and upper management
• Maintain current working knowledge of ICD-10-CM, CPT, HCPCS coding
• Stay up-to-date on coding compliance and reimbursement procedures related to top Medicare Risk Adjustment HCCs
• Support and participate in process and quality improvement initiatives, implementation/execution
• Organize and manage multiple priorities and/or projects using appropriate methodologies and tools
• Solve problems and encourage others in collaborative problem-solving
• Maintain a methodical and detail-oriented approach to work
• Work independently with minimum supervision, demonstrating excellent reliability, positive attitude, and the ability to work timely and effectively under strict deadlines
• Maintain the ability to work in an environment with PHI / PII data
• Adhere to all company policies and procedures

Requirements

Essential Qualifications

• High School Diploma / GED
• Certification from either AAPC and/or AHIMA (CPC, CCS, CRC, or CPMA)
• Must be 18 years of age or older
• 3 years of HCC/Risk Adjustment coding experience
• 1 year of coder-based auditing experience
• Knowledge of coding industry standards and practices
• Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort/filter, and work within tables), and Microsoft Outlook (email and calendar management)
• Computer proficiency with direct messaging applications (Microsoft Teams, Webex, etc.)
• Ability to train for the first 4 weeks between Monday - Friday, 08:00 AM - 05:00 PM, and then work flexible shifts
• Ability to work full-time, including the flexibility to work occasional overtime given the business need

Preferred Qualifications

• Experience with peer-to-peer reviews

Skills and Competencies

To succeed in this role, you will need:

• Excellent verbal and written communication skills, including the ability to effectively communicate with internal and external customers
• The ability to maintain strong relationships with multiple stakeholders
• The ability to communicate with different professional levels
• The ability to work under pressure and meet deadlines while maintaining a positive attitude and providing exemplary customer service
• The ability to work independently and carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices
• A high level of ethics, integrity, discretion, and confidentiality
• Knowledge of customer specifications

Telecommuting Requirements

As a remote worker, you will be required to:

• Keep all company-sensitive documents secure (if applicable)
• Establish a dedicated work area that is separated from other living areas and provides information privacy
• Live in a location that can receive a UnitedHealth Group-approved high-speed internet connection or leverage an existing high-speed internet service

Compensation and Benefits

We offer a competitive salary and a comprehensive benefits package, including:

• A competitive salary range of $23.22 - $45.43 per hour (for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, or Washington, D.C. residents)
• A comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

Career Growth Opportunities and Learning Benefits

At UnitedHealth Group, we are committed to helping our employees grow and develop their skills. We offer:

• Opportunities for career advancement
• Professional development and training programs
• Leadership development initiatives

Work Environment and Company Culture

Our company culture is built on the principles of:

• Innovation
• Collaboration
• Integrity
• Respect
• Excellence

We strive to create a work environment that is inclusive, diverse, and supportive of all employees.

Why Join UnitedHealth Group?

By joining UnitedHealth Group, you will become part of a team that is dedicated to helping people live healthier lives and making the health system work better for everyone. We offer:

• A sense of purpose and fulfillment
• Opportunities for growth and development
• A competitive salary and benefits package
• A diverse and inclusive work environment

How to Apply

If this role sounds like a perfect fit, don't hesitate. Apply today and let's build the future together.

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.