589486 - Senior Medical Coding Compliance Auditor - Telecommuting Position - Full-time / Part-time

Optum360, part of the UnitedHealth Group family of companies, is a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage all our resources to bring financial clarity and a full suite of revenue management services to health care providers nationwide. We are currently looking for an experienced Senior Medical Coding Compliance Auditor to join our dynamic Coding Compliance team. The people who work at Optum are among the brightest and most inventive in the industry. Work alongside us today and discover a culture of integrity, compassion, relationships, innovation and performance. Our team enjoys conversation-changing, life-changing, world-changing opportunities throughout their careers. Join us and see what it's like to do your life's best work.(sm)

The Senior Medical Coding Compliance Auditor will function within the Optum360 Coding Compliance Department to ensure that Optum's professional coding and documentation practices are compliant, efficient, accurate and consistent.  This is a telecommuting / work from home position, and ideal candidates will be located in Phoenix AZ, California, and/or Nevada, though stellar candidates from other areas of the United States may also be considered.  This position will require approximately 25% overnight travel to client locations to perform onsite audits of their coding operations.

Primary Responsibilities:

• Serve as a resource for O360 clients, clinics, physicians, coders and staff related to coding and documentation of professional services


• Analyze the effectiveness and efficiency of coding processes in client clinics


• Evaluate systems and processes related to or impacting coding and recommend system process improvements, which will enhance the organization's efficiency


• Work with Optum 360 Compliance department to educate professional coders regarding relevant laws, regulations and standards


• Assist the organization and clients in reviews relating to internal or external investigations


• Research, develop and present education programs and presentations to physicians, coders, management and others as assigned


• Monitor and track corporate compliance initiatives related to coding


• Develop audit/review functions and processes including scope, conclusions, reports and corrective action matrix for identified risk areas, including evaluation and management documentation


• Under direction of Senior Compliance Manager, Optum 360 Compliance and Legal Department perform audits/reviews of professional coding/billing within client facilities for the purpose of assessing the accuracy of the  coding and operations


• Prepare audit reports in a timely manner and provide recommendations for corrective action and a timeline


• Utilize coding software and other computer programs


• Contribute ideas to the departmental work plan and participate in departmental staff meetings

Required Qualifications:

• 3+ years of working experience in a role responsible for multi-specialty coding (preferably in a teaching hospital environment)


• Professional certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS-P)


• Demonstrated ability to develop and present education programs for coders, physicians, and other health care providers


• Experience conducting coding reviews, including but not limited to evaluation and management claim audits


• Ability to communicate clearly both verbally and in writing, including ability to present ideas, concepts and educational presentations effectively across organizational levels


• Ability to function effectively in a dynamic and challenging environment and to affect change if necessary


• Self-starter with proven ability to deliver operational compliance


• Demonstrated ability to analyze problems and issues from a variety of perspectives and understand the legal, reimbursement, clinical, and operational impact


• Ability/flexibility to travel as needed; up to 25% of your time will be overnight travel to client locations


• Intermediate or better proficiency with MS Word

Preferred Qualifications:

• Undergraduate degree


• Certification as a Certified Professional Medical Auditor (CPMA)


• Willingness to network within the coding community including membership in AAPC, HCCA and/or AHIMA

Health care isn't just changing. It's growing more complex every day. ICD10 replaces ICD9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. And that's what fueled these exciting new opportunities. Optum360 is a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage all our resources to bring financial clarity and a full suite of revenue management services to health care providers nationwide. If you're looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: 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.

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