Acute Hospital Inpatient Coding Compliance Auditor (CCS) - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.The Inpatient Coding Compliance Auditor will provide expert coding audit services across various acute hospital organizations for inpatient and outpatient facility services. Review medical record documentation and related coding of hospital encounters utilizing the ICD-10-CM/PCS classification system and CPT. Identify high-risk areas of coding for audits. Verify coding accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, official coding guidelines and industry standards. This individual will utilize their expertise to analyze audit results, identify patterns and trends and recommend corrective actions. This individual will also evaluate clinical criteria.You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:

Perform coding compliance and quality audits in support of Optum Insight Provider's Compliance Program and client expectations

Analyze and interpret documentation from inpatient medical records

Clearly document audit findings, cite appropriate coding guideline references and calculate error rates

Utilize expertise to analyze audit results, identify patterns and trends and recommend corrective actions

Articulate audit findings appropriate for audience. Prepare written audit reports summarizing audit findings and any corrective action necessary to mitigate risk

Serve as an expert coding resource to client organizations and provide expert coding guidance

Evaluate medical record documentation for clinical criteria and missed query opportunities

Stay abreast of relevant official coding guidelines and other industry official guidance

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:

Certified Coding Specialist (CCS) certification from the American Health Information Management Association (AHIMA)

6+ years acute inpatient hospital coding experience using ICD-10-CM/PCS classification

Extensive, current knowledge of acute hospital official coding guidelines, the ICD-10-CM/PCS classification system, MS/APR-DRG systems, and American Hospital Association (AHA) Coding Clinic® for ICD-10-CM/PCS

Working knowledge of Microsoft Office applications such as Excel, Word, Outlook, OneNote and Teams

Working knowledge of common Electronic Health Records (EHR), encoder/grouper and computer assisted coding applications

Preferred Qualifications:

Bachelor’s Degree in related concentration such as Health Information Management or Health Information Technology or equivalent experience

Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) certification from AHIMA

CDIP or CDIS certification

6+ years of inpatient coding audit experience

3+ years of CDI experience

Experience using the Optum computer assisted coding (eCAC) product, and/or other common CAC/encoder software applications

Experience using Cerner, Epic and/or other electronic health record (EHR) applications

Current knowledge and current or past experience coding acute hospital outpatient accounts such as outpatient surgery and emergency room (ED) encounters using CPT®.

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $85,000 to $167,300. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.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.