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Quality Assurance Auditor - Remote job in Miami at UnitedHealth Group

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Quality Assurance Auditor - Remote at UnitedHealth Group

Quality Assurance Auditor - Remote

UnitedHealth Group Work from Home/Remote Full-Time

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

This role will provide coding quality auditing services tensure compliance with Optum and CMS coding guidelines and accuracy of coding data reported. Must maintain compliance with Optum Coding Guidelines/policies. The minimum productivity goal is set by project, with minimum 96% coding accuracy rate required. 

You’ll enjoy the flexibility twork remotely* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Assists with execution of the daily activities of the National Quality Assurance program

  • Performs first level quality audits on vendor coding results

  • Performs first level quality audits on Care Delivery coding teams coding results

  • Provides support and assist all markets within Care Delivery on various coding initiatives, such as concurrent review, query compliance audits and retrospective coding quality reviews

  • Must be able twork with multiple coding tools and EMR systems

  • Ensure that Optum Coding Guidelines are consistently applied in all processes

  • Identifies issues and trends in coding and documentation that affect coding accuracy

  • Provides input and valuable feedback on audit results

  • Recommends process improvement

  • Perform all other related duties as assigned

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.

Required Qualifications:

  • Coding Certification required (CPC, COC, CIC, CCS, CCS-P, or RHIT; the CPC-A or CCA designation is not acceptable)

  • 4+ years recent experience ICD-10-CM coding, preferably in a Managed Care setting, with solid attention tdetail, and proficient knowledge of ICD-10-CM coding guidelines

  • 2+ years recent Medicare Risk Adjustment experience (HCC coding) with proficient knowledge of CMSHCC model and guidelines

  • 1+ years recent experience in a coding auditor role -  auditing the work of other coders and providing feedback/coaching

  • Compliant Physician query experience/knowledge

  • Able to work during normal business hours, Monday-Friday 8am-5pm CST (flexibility tstart 8 hour shift earlier or later after successful completion of training)

  • Able to continuously meet the requirements for a telecommuter, i.e. live in a location that can receive a UnitedHealth Group approved high speed internet connection, have a secure designated office space tmaintain PHI, meet or exceed all performance expectations

Preferred Qualifications:

  • Bachelor’s degree

  • CRC (Certified Risk Coder) in addition trequired coding certification

  • Inpatient coding experience

  • Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)

  • Excellent organizational, problem solving, and critical thinking skills

  • Excellent verbal/written communication and interpersonal skills


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Colorado, Connecticut or Nevada Residents Only: The hourly range for Coloradresidents is $21.68 t$38.56. The hourly range for Connecticut / Nevada residents is $23.94 t$42.40. Pay is based on several factors including but not limited teducation, work experience, certifications, etc. In addition tyour salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject teligibility requirements). Nmatter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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