Coding Quality Analyst - Farmington, Connecticut - Full-time / Part-time

Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member - centric approach to care. You’ll act as a voice for our members, guiding the development of comprehensive care plans that will help others live healthier lives. Here’s your opportunity to discover your life's best work.(sm)  
 
The Clinical Quality Analyst evaluates clinical documentation to ensure accurate coding.  his position is also responsible for timely communication of identified quality issues concerning documentation back to the provider. The ultimate goal is improvement in coding accuracy across the network. The minimum productivity goal is determined by project (10 - 15 encounters per hour) with an expectation of minimum 95% accuracy rate.
 
Primary Responsibilities:

Develops rapport with providers
Performs audits of clinical documentation to ensure all assigned ICD codes are accurate and supported based on coding guidelines
Queries provider when documentation is conflicting, ambiguous or incomplete
Identifies issues and trends in coding and documentation
Responsible for communicating with physicians to provide valuable feedback on medical record review findings
Provides education on proper clinical documentation, compliance, and coding guidelines

Required Qualifications:  

Associate’s degree or higher - significant relevant work experience may substitute for degree
3+ years of experience ICD - 9 / 10 coding / auditing, preferably in a Managed Care setting, with strong attention to detail and high accuracy rate
2+ years of recent Medicare Risk Adjustment / HCC Coding experience
Proficient knowledge of CMS - HCC model and guidelines
Coding Certification required (CPC, CCS, CCS - P, or RHIT;  CPC - A or CCA designation is not acceptable)
2+ years of recent Provider education experience
Compliant Physician query experience
Must be local to the Farmington, CT area – or within reasonable driving distance. Will primarily work remotely, but will be required to attend on - site meetings or travel to provider offices as needed
Up to 25% travel (locally and non - locally to provider offices) as determined by business need
Ability to work a flexible schedule to meet business needs
ICD - 10 proficient
Previous experience using diagnosis coding data and trends to identify training opportunities
Excellent time management, organizational, and prioritization skills with ability to balance multiple priorities and make changes to work as the project needs dictate
Strong oral and written communication skills
Microsoft Office proficiency (Word, Excel & Outlook)
Must be able to continuously meet the requirements for a telecommuter, i.e. live in a location that can receive a UnitedHealth Group approved high speed internet connection, have a secure designated office space to maintain PHI, meet or exceed all performance expectations
Preferred: Qualifications:

Bachelor’s Degree
CRC (Certified Risk Coder) in addition to required coding certification
1+ years HEDIS / STARS experience
Previous experience with WebEx or similar virtual meeting tools
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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: coding, quality analyst, Farmington, Connecticut, CT, telecommute, telecommuting, telecommuter