UnitedHealth Group.

  • Atlanta, GA


  • $64,800-116,000 per year.

  • Long-term.

  • Full-time.

Primary Duties:

  • Perform coding compliance and quality audits in support of Optum360’s Compliance Program and customer expectations
  • Examine and translate documents from medical records
  • Clearly record audit findings and determine coding mistake rates
  • Supply feedback and education as proper based on findings
  • Articulate audit findings proper to the audience. Prepare written audit analysis and summary reports, consisting of corrective action needed to mitigate risk
  • Conduct coding and billing audits as requested
  • Assist client company with internal or external Compliance reviews
  • Educate and audit onshore and offshore coders and auditors
  • Stay abreast of appropriate Outpatient coding and billing guidelines
  • Research study, establish and present education to coders based on private and group audit analysis
  • Conduct auditor peer review audits as asked for
  • Expert spoken and written communication skills
  • Proficient in Excel
  • Ability to focus on several tasks and several spreadsheets, files and reports
  • Serves as a resource for interventional Outpatient Audits

You’ll be rewarded and acknowledged for your performance in an environment that will challenge you and give you clear instructions on what it takes to be successful in your role as well as provide advancement for other roles you might be interested in.

Needed Credentials:

  • 5 years Outpatient Coding Experience
  • 5 years of Outpatient Audit experience to include interventional specializeds for cardiology and radiology
  • Professional knowledge of NCCI/OCE billing edits as it relates to outpatient coding, auditing and billing
  • Comprehensive knowledge of ICD-10 CM and CPT, consisting of CPT-4 codes relevant to CVIR coding/auditing
  • Comprehensive experience with various documents and Electronic Medical Records
  • Extensive experience in all Outpatient chart types
  • Market Understanding of Medicare policies and payment policies, consisting of OPPS
  • Registered Health Information Administrator (RHIA) and/or Registered Health Information Professional (RHIT) and/or Certified Coding Expert (CCS-P), and/or Qualified Expert Coding (CPC), and/or Certified Coding Professional (CCS), and/or Licensed Coding Specialist– Expert (CCS-P)
  • Certified Interventional Radiology Coder (CIRCC)
  • If you require to enter a work site for any factor, you will be required to evaluate for signs using the ProtectWell mobile app, Interactive Voice Reaction (i.e., entering your symptoms by means of phone system) or similar UnitedHealth Group-approved symptom screener.

    CareerBuilder.

  • View & Apply.