Remote Facility Coding Auditor

Claims Considering making an application for this job Check all the details in this job description, and then click on Apply. _This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.Optum Insight** is improving the flow of health data and information to create a more connected system. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? The **Outpatient Facility Auditor** (Senior Recovery Resolution Analyst) performs medical record audits of identified suspect CPT codes, ICD-10-CM diagnosis codes, and HCPCS, as well as potential errors in billing. The Outpatient Facility Auditor validates codes by examining medical record for documentation of all procedures as well as coding. This position is full time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime or weekends. This will be on the job training and the hours during training will be normal business hours from Monday - Friday. **Performs all necessary duties related to the Outpatient Audit process including: + Maintain a dedicated HIPAA-compliant home office space with access to high speed cable internet available + Review of outpatient hospital and ambulatory surgery centers medical records all associated documentation to determine the accuracy and appropriateness of outpatient coding and billing practices + Create audit summary documentation + Enter status and results into Claim Reviewer system + Responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally, verbally or in writing 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. **High School Diploma / GED + Must have one of the following coding certifications: Must be 18 years of age OR older + 2+ years of experience with medical code auditing in an outpatient facility (hospital and / or ASC (ambulatory surgery center) + Advanced knowledge in CPT / HCPCS coding and National Correct Coding Initiative (NCCI) edit review / resolution + Proficient in PC Windows environment + Ability to work any of our full time (40 hours / week), 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm from Monday - Friday, including the flexibility to work occasional overtime or weekends given the business need **RN, RHIT, OR RHIA with a coding credential + Experience with defending insurance company hospital outpatient coding denials and coding auditing experience + Understanding of commercial insurance reimbursement + Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service **Direct, but moderately supervised, impact on quality and efficiency of services OR operation of company OR revenues / expenses + Impact on quality and efficiency of services or operation of company + All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $28.94 - $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. xywuqvp Remote working/work at home options are available for this role.