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HCC Coding Auditor- Brentwood, TN

UnitedHealth Group

Brentwood, TN
Job Code:
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Job Details

HCC Coding Auditor- Brentwood, TN(Job Number:708646)

Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member-centric approach to care. As a Senior Quality Analyst you will monitor and support health plan quality improvement initiatives with particular emphasis on compliance with state and federal regulatory and accreditation requirements. You'll act as a voice for our members, guiding the development of comprehensive care plans that will help others live healthier lives. Here's your opportunity to discover your life's best work.(sm)

UnitedHealthcare Quality Management & Performance is an integrated team serving all UnitedHealthcare businesses. We're focused on improving the health of our members, enhancing our operational effectiveness and reinforcing brand and reputation for high-quality health plans. Join us and help guide our efforts to improve the patient experience. It takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment.

This role will provide ongoing auditing and feedback to our team of Medical Coders and Auditors

Primary Responsibilities:
  • Perform a detailed review of medical records to ensure the ICD-10-CM code(s) was coded correctly during the coding and / or auditing process
  • Document audit findings in database and/or MS Excel
  • Increase coding accuracy of coders and auditors
  • Ensure auditors are auditing in accordance with guidelines
  • Reviews and analyzes medical record documentation in accordance with established industry and government regulations, AHA Coding Clinic, and departmental policies and procedures
  • Ensures the accuracy, integrity and quality of coding selections per established regulations, and they are supported by documentation, within the body of the medical record
  • Execute the tactical day-to-day activities of the Quality Assurance process
  • Perform, summarize and report on the Quality Assurance audits
  • Creates performance improvement plan as needed
  • Mastery of Optum coding guidelines, applications and practices. Subject matter expert
  • Review QA findings with individual coders. Provide coaching and mentorship
  • Analyze QA results and create reports
  • Collaborate with training department to develop training materials based upon QA results
  • Communicates with management regarding audit findings

Job Quality Management
Primary Location US-TN-Brentwood
Other Location 
Organization Optum Ops-Risk Adjustment
Schedule Full-time
Number of Openings 2
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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