16 days old

Senior Outpatient Coding Auditor - IVR / CVIR - Telecommute Nationwide - 913989

Atlanta, GA 30303 Work Remotely
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  • Job Code
    913989

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 doyour life's best work.(sm)

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The OP Coding Auditor IVR/CVIR is an auditor position which conducts audits across clients in Outpatient chart types and codes sets, focusing on cardiovascular and interventional radiology (IVR/CVIR). He/she reviews documentation and related coding to audit ICD-10-CM, CPT Evaluation and Management, HCPCS, and coding and billing accuracy to ensure consistency with relevant laws, regulations, coding and billing standards. The Senior Quality Interventional Analyst is responsible for all interventional audits which includes interventional radiology and cardiology service types. The Senior Quality Interventional Analyst primarily conducts regular audits and provides education, feedback and analysis to coders utilizing expertise to research and respond to challenging coding/auditing questions. The auditor is responsible for providing feedback based on analysis of the coding audit results to identify patterns and trends and providing summary reports.

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Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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Primary Responsibilities:

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  • Perform coding compliance and quality audits in support of Optum360's Compliance Program and client expectations""
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    • Analyze and interpret documentation from medical records
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    • Clearly document audit findings and calculate coding error rates
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    • Provide feedback and education as appropriate based on findings
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    • Articulate audit findings appropriate to the audience. Prepare written auditanalysis and summary reports, including corrective action necessary to mitigaterisk
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  • Conduct coding and billing audits as requested
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  • Assist client organization with internal or external Compliance reviews
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  • Educate and audit onshore and offshore coders and auditors
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  • Stay abreast of relevant Outpatient coding and billing guidelines
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  • Research, develop and present education to coders based on individual and teamaudit analysis
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  • Conduct auditor peer review audits as requested
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  • Professional verbal and written communication skills
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  • Proficient in Excel
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  • Ability to prioritize multiple assignments and multiple spreadsheets, documentsand reports
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  • Serves as a resource for interventional Outpatient Audits
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Youll 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.

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Required Qualifications:

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  • 5+ years of Outpatient Coding/Audit experience
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  • Expert knowledge of NCCI/OCE billing edits as it relates to outpatient coding, auditing andbilling
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  • Thorough knowledge of ICD-10 CM and CPT, including CPT-4 codes relevant to CVIR coding/auditing
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  • Extensive experience with various documentation and Electronic Medical Records
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  • Extensive experience in all Outpatient chart types
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  • Industry Knowledge of Medicare regulations and payment policies, including OPPS
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  • Registered Health Information Administrator (RHIA) and/or Registered Health Information Technician (RHIT) and/or Certified Coding Specialist (CCS-P), and/or Certified Professional Coding (CPC), and/or Certified Coding Specialist (CCS), and/or Certified Coding Specialist Professional (CCS-P)
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  • Certified Interventional Radiology Coder (CIRCC)
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • CPMA
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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.

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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 doyour life's best work (sm)

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Colorado Residents Only:The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Keywords: CPC, RHIT, RHIA, CCS, CCS-P, CCS, CIRCC, CPMA, Outpatient Auditor, Outpatient Coder, Telecommuter

Posted: 2021-02-09 Expires: 2021-03-11

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Senior Outpatient Coding Auditor - IVR / CVIR - Telecommute Nationwide - 913989

UnitedHealth Group
Atlanta, GA 30303

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