Medical Coding Quality Analyst - Telecommute - Full-time / Part-time

The OptumHealth Behavioral Solutions (OHBS) PNI Coding Quality Analyst is responsible for coding and auditing services specific to administrative fraud, waste and abuse cases. This includes the analysis, documentation, explanation and translation of medical and behavioral diagnosis and procedures. The Medical Coder/Analyst will support the OHBS PNI in research, issues and inquires that relate to their reviews and policies on Medical Coding/Auditing.
 
Primary Responsibilities:

Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent, utilizing most current reference materials to include, but not limited to: Current Procedural Terminology (CPT), Internal Classification of Disease (ICD-9/ICD-10) and Healthcare Common Procedure Coding System (HCPCs) guidelines
Documents Decisions on reviews through notations and enters notes in appropriate company systems
Ability to discuss and present on decisions made to appropriate internal and external individuals/groups
Coordinate with team members to understand trends and schemes related to billing issues/coding trends

Required Qualifications:


2+ years of experience in coding and medical billing
Associates degree or related field experience  

Clinical and/or coding expertise in a Physician office, SNF, ALF, Hospital setting, and/or billing/office
Strong oral and written communication skills
Strong organizational/time management skills and be able to work independently or as a team
Strong knowledge of CMS 1500 and UB04 data elements
Strong knowledge of ICD, CPT, HCPC and Revenue Codes
Ability to support heavy work load volume and meet unit standards while engaging multiple priorities
Current CPC or CCS-P Certification
Preferred Qualifications: 

Behavioral Health experience
Problem solving skills
Serves as a resource on moderately complex issues related to coding / billing   Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM 
Diversity creates a healthier atmosphere: 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.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
 
 
Job Keywords: CPC, Medical Coder, ICD-10, Eden Prairie, MN, Minnesota