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Coding Quality Analyst - San Diego, CA

UnitedHealth Group

San Diego, CA
Job Code:
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Job Details

Coding Quality Analyst - San Diego, CA(Job Number:729450)

For those who want to invent the future of health care, here's your opportunity. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm)
Primary Responsibilities:
  • Abstract and code complex outpatient and inpatient medical records for psychiatric patients using International Coding of Diseases (ICD-10)
  • Review medical records for appropriate documentation to support ICD-10 codes
  • Properly document codes in the electronic medical record and other systems
  • Assist with coding and billing medical record audits
  • Evaluate medical records for coding completeness and accuracy in conformance with current standards and regulations
  • Provide feedback to physicians to clarify information for coding purposes
  • Establish and maintain processes to effectively code inpatient and emergency psychiatric unit patients
  • Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information
  • Follow up with providers as necessary when responses to queries are not provided in a timely basis
  • Leverage understanding of disease process to identify and extract relevant details and data within clinical documentation and make determinations or identify appropriate medical codes
  • Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines
  • Develop training materials for coding and auditing for external partners, stakeholders and internal departments
  • Conduct audits of inpatient professional services to ensure documentation is present for claims to be substantiated and prepares findings
  • Conduct targeted audits of providers with applicable indicators to ensure documentation is present for claims to be substantiated and prepares findings
  • Participate in quality improvement projects and activities
  • Other duties as assigned

Job Medical Coding
Primary Location US-CA-San Diego
Other Location 
Organization Optum Behav Hlth Public Sector
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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