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Coding Quality Analyst - National Remote

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WorkatHome-JobBoard

5d ago

  • Job
    Full-time
    Mid Level
  • Data
    Healthcare
  • Carver
    Remote

AI generated summary

  • You must have a high school diploma, 3+ years in Risk Adjustment coding, AAPC/AHIMA certification, MS Office skills, and be able to train 4 weeks full-time, then work flexible hours.
  • You will analyze medical coding guidelines, review coded records for accuracy, provide feedback, support quality initiatives, and manage multiple projects while ensuring compliance with coding standards.

Requirements

  • High School Diploma / GED
  • Must be 18 years of age OR older
  • 3+ years with Risk Adjustment coding and auditing experience.
  • Certification from either AAPC and/or AHIMA (CPC, CCS, CRC or CPMA)
  • Knowledge of coding industry standards and practices
  • Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
  • Computer proficiency with direct messaging applications (Microsoft Teams, Webex, etc.)
  • Ability to train for the first 4 weeks between Monday - Friday, 08:00AM -05:00PM and then candidate can work flexible shift after.
  • Ability to work full-time, Monday - Friday between 8:00am - 5:00pm including the flexibility to work occasional overtime given the business need

Responsibilities

  • Accurately read and analyze CMS as well as client specific coding guidelines for peer-to-peer and vendor over-reads
  • Responsible for reviewing medical records previously coded by peer to determine and ensure accuracy, completeness, specificity, and appropriateness of diagnosis codes based on documentation in accordance with established CMS and client-specific guidelines for MRA and ACA coding
  • Prepares and presents written feedback to coding staff and upper management
  • Current working knowledge of ICD-10-CM, CPT, HCPCS coding
  • Maintain accurate knowledge of coding compliance and reimbursement procedures related to top Medicare Risk Adjustment HCC's
  • Requires a strong knowledge of diagnostic coding and HCC documentation requirements
  • Semi-flexible schedule with requirement of 40-hour work week
  • Support and participate in process and quality improvement initiatives, implementation/execution
  • You are good at organizing and managing multiple priorities and or projects by using appropriate methodologies and tools
  • Problem solving, you are a problem solver with the ability to encourage others in collaborative problem solving
  • Methodical and detail-oriented
  • Requires strong ability to work independently with minimum supervision, excellent reliability, positive attitude, and demonstrated ability to work timely and effectively under strict deadlines
  • Requires an individual to maintain the ability to work in an environment with PHI / PII data
  • May be assigned other duties
  • Must maintain compliance with all company policies and procedures

FAQs

Do we support remote work?

Yes, this position is fully remote, allowing you to telecommute from anywhere within the U.S.

What are the primary responsibilities of the Coding Quality Analyst?

The Coding Quality Analyst is responsible for performing peer-to-peer overreads, reviewing medical records for accuracy and compliance, preparing feedback for coding staff, and participating in process improvement initiatives.

What are the required qualifications for the position?

Candidates must have a High School Diploma or GED, at least 3 years of Risk Adjustment coding and auditing experience, and certification from either AAPC or AHIMA (CPC, CCS, CRC, or CPMA).

Is there an on-the-job training period?

Yes, there is 4 weeks of on-the-job training from Monday to Friday, 8:00 AM to 5:00 PM.

What is the expected work schedule?

This is a full-time position requiring a 40-hour work week, Monday to Friday, within the hours of 8:00 AM to 5:00 PM, with some flexibility for shifts and occasional overtime.

Are there specific coding knowledge requirements?

Yes, a current working knowledge of ICD-10-CM, CPT, and HCPCS coding is required, along with an understanding of coding compliance and reimbursement procedures.

What technical skills are necessary for this role?

Candidates should be proficient in Microsoft Word, Excel, and Outlook, as well as have computer proficiency with direct messaging applications like Microsoft Teams and Webex.

Are there any preferred qualifications for applicants?

Experience with peer-to-peer reviews is listed as a preferred qualification.

What soft skills are valued for this position?

Strong verbal and written communication skills, relationship-building capabilities, the ability to work under pressure, and a high level of ethics and integrity are highly valued.

Is there a salary range for this position?

Yes, the hourly range for this position is $23.22 - $45.43, based on factors such as local labor markets, education, and experience.

What benefits does UnitedHealth Group offer employees?

UnitedHealth Group offers a comprehensive benefits package, which includes incentive and recognition programs, an equity stock purchase option, and 401k contributions, among other benefits.

What is UnitedHealth Group’s commitment to diversity?

UnitedHealth Group is committed to diversity and inclusion, valuing every individual's ability to live their healthiest life and addressing health disparities experienced by marginalized groups.

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