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Risk Adjustment Coder - Quality Assurance Auditor – Telecommute!
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Houston, TX Houston, Texas |
About this job
Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Due to our expanding business, UnitedHealth Group is seeking Quality Assurance Auditor who share our passion for helping people live healthier lives to join our team. It's an inspiring role and it can inspire your career. For those who want to invent the future of health care, here's your opportunity. Find out more about these opportunities to do your life's best work.(SM)
The Quality Assurance Auditor provides coding and coding auditing services . This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
The Quality Assurance Auditor provides coding and coding auditing services . This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
This is a work at home, telecommute position. Monday-Friday, days!
Responsibilities:
- Perform ongoing review of medical record charts for the appropriate ICD-9 code(s) according to CMS and ICD-9 guidelines
- Receive assigned medical charts to code
- Review medical charts electronically using a computer
- Abstract and code diagnosis and documentation information
- Research and resolution of coding projects as assigned
- Document requested information from the medical record
- Determine valid encounters including legibility and valid signature requirements
- Identify valid face to face encounters
- Coder is responsible for meeting daily production goal and quality goal of averaging 95% accuracy rate
- Attend conference calls as necessary to provide information and/or feedback
- Execute the tactical day-to-day activities of the Quality Assurance process
- Mastery of Optum coding guidelines, applications and practices. Subject matter expert
- Perform, summarize and report on the Quality Assurance audits
- Review QA findings with individual coders. Provide coaching and mentorship
- Analyze QA results and create reports
- Collaborate with training department to develop training materials based upon QA results
- Communicates with management regarding audit finding
Requirements
Required Qualifications:
- High School Diploma or GED
- 3+ years of professional coding experience
- Have had a Coding Certification to include the following: CPC, CCS, RHIA, or RHIT (no CPC-A, RHIT-A, etc.) for at least 3 years
- Ability to identify and code diagnosis codes according to CMS and ICD-9 standards
- Anatomy knowledge
- Advanced knowledge of coding guidelines
- Computer proficiency in a Windows environment, including MS Word and Excel
- Pharmacology knowledge
- Risk Adjustment/ HCC coding experience
Preferred Qualifications:
- Previous facility based coding experience
- Previous managed care experience
- Experience with HEDIS
OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.
At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Keywords: Telecommute, Telecommuting, work from home, CPC, CCS, RHIA, RHIT, HCC, Medical Coder, AAPC, AHIMA, auditing, Risk Adjustment, HCC, Medicare, CMS
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