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in Winston Salem, NC

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Hours Full-time, Part-time
Location Winston Salem, NC
Winston Salem, North Carolina

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 Clinical Quality Assurance Auditors 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.

 

Locations:  Franklin, TN and Overland Park, KS; Telecommuting option

 

This role will provide ongoing auditing and feedback to our team of Medical Coders, Sr Coders, and RN HEDIS Abstractors!

 

Responsibilities:

 


  • Perform a detailed review of medical records to ensure the ICD-9-CM code(s) was coded correctly during the coding process.

  • Document audit findings in database and/or MS Excel.

  • Increase coding accuracy and capture rate of coders

  • Reviews and analyzes medical record documentation in accordance with established industry and government regulations, and departmental policies and procedures

  • Ensures the accuracy, integrity and quality of coding selections per established regulations, and they are supported by documentation, within the body of the medical record.

  • Execute the tactical day-to-day activities of the Quality Assurance process.

  • Perform, summarize and report on the Quality Assurance audits.

  • Creates performance improvement plan as needed

  • Mastery of Optum coding guidelines, applications and practices. Subject matter expert.

  • 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 findings.

Requirements

Qualifications:


  • RN with current, unrestricted license and coding experience; LPN with coding certification and experience;  or RHIT or RHIA certified

  • 5+ years of clinical experience or clinical coding experience

  • Three or more years of coding or abstraction experience, with ability to identify and code diagnosis codes according to CMS and ICD-9 standards

  • Strong knowledge base of HEDIS measures and NCQA

  • Audit and medical chart review experience

  • Proficient in MS Office

  • Flexibility in work hours and location

Preferred Qualifications:


  • HEDIS abstraction experience

  • Bachelor's degree

  • STARS or Quality experience

  • Acute care clinical experience

  • Inpatient coding experience in an acute care facility

  • Coding certification to include the following: CPC, CPC-H, CCS, CCA, RHIA, and RHIT

  • Previous inpatient coding auditing experience

 

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.

 

 


***UnitedHealth Group is hosting a Virtual Career Fair on Friday, July 25th, from 12PM CDT – 2PM CDT for medical coding professionals. You will have the opportunity to chat live with a recruiter. Join us at this exciting event to learn more about how you can help people live healthier lives. Learn more and register !***


 



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: CPC, CCS, RHIA, RHIT, HCC, Medical Coder, AAPC, AHIMA, auditing, Franklin, TN, Tennessee, Overland Park, KS, Kansas, RN, LPN, LVN, Telecommute, Work at Home, Coder, Auditor