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Inpatient Coding Compliance Auditor – Telecommute

UnitedHealth Group


Location:
Bellevue, WA
Date:
04/27/2017
Job Code:
1743744
Apply on the Company Site
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Job Details


Inpatient Coding Compliance Auditor – Telecommute(Job Number:712646)
Description

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)

The Inpatient Coding Compliance Auditor provides auditing services across clients in Inpatient chart types and code sets. Reviews documentation and related coding, auditing correct assignment of CPT, ICD-10 to verify coding and billing accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, coding and billing standards. The Coding Compliance Auditor will provide education to coders on audit results, utilize expertise to research and respond to challenging coding questions, develop and provide coding education and evaluate audit results to recommend corrective actions. The Coding Compliance Auditor will have the expertise to respond to client requests to conduct ad hoc Inpatient coding and billing audits.
 
Primary Responsibilities:
  • Perform coding compliance and quality audits in support of Optum360's Compliance Program and client expectations
    • Analyze and interpret documentation from medical records
    • Clearly document audit findings and calculate billing error rates
    • Provide feedback and education as appropriate depending on findings
    • Articulate audit findings appropriate for audience. Prepare written audit reports as needed summarizing audit findings and any corrective action necessary to mitigate risk
  • Conduct ad hoc coding and billing audits as requested
  • Assist client organization with internal or external Compliance reviews
  • Educate and audit offshore coders and auditors as well as audit and educate new coders
  • Stay abreast of relevant LCDs, NCDs, billing and coding guidelines concerning the current areas of audit focus
  • Research, develop and present education programs to physicians, coders and management as requested
  • Conduct auditor peer review audits as requested

Job Quality Management
Primary Location US-WA-Bellevue
Other Location 
Organization O360 Admin
Schedule Full-time
Number of Openings 3
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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