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Optum Coding Quality Assurance Auditor in Everett, Washington

Optum is seeking a Coding Quality Assurance Auditor to join their team full time. This is a fully remote position.

The Coding Quality Assurance Auditor functions as an integral member of the team and demonstrates proficiency in all aspects of outpatient coding. The Coding Quality Assurance Auditor ensures that the Coder’s audits are accurate and meet the department’s quality goals.

The Coding Quality Assurance Auditor is responsible for and not limited to:

  • Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer.

  • Represents the Company in a professional manner, following all Company policies and procedures.

  • Uses, protects, and discloses patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

  • Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials.

  • Complies with all aspects of Coding and Corporate Compliance standards.

  • Abides by all ethical standards and adheres to official coding guidelines.

  • Works with Supervisor to provide oversight of other coder/auditor team members as delegated.

  • Completes weekly audits of coder/auditor team members as assigned by Supervisor.

  • Provides coding and audit results reporting to Supervisor

  • Provides feedback and training to teammates as requested by Supervisor.

  • Assists in the preparation of training materials.

  • Assists with training for coder/auditor team members.

  • Assists Supervisor with researching, analyzing, and responding to inquiries regarding compliance, coding, and inappropriate coding.

  • Meets quality and productivity standards and deadlines established by Supervisor.

  • Performs related work and projects as required.

  • Performs other duties as assigned.

Required Experience and Credentials:

  • High School diploma, GED or equivalent.

  • 3-5 years of coding experience in a Primary Care environment.

  • An excellent understanding of ICD-10-CM coding classification and guidelines.

  • An excellent understanding of CPT coding and guidelines within a Primary Care environment

  • AAPC approved coding certification program.

  • CCDS: Certified Clinical Documentation Specialist (Association of Clinical Documentation Improvement Specialists)

  • CCS: Certified Coding Specialist

  • CDEO: Certified Documentation Expert – Outpatient

  • CDIP: Certified Documentation Improvement Practitioner

  • COC: Certified Outpatient Coding Professional; formerly Certified Professional Coding Professional – Hospital Outpatient (CPC-H)

  • CPC: Certified Professional Coding Professional

  • CPC-P: Certified Professional Coding Professional – Payer

  • CRC: Certified Risk Adjustment Coding Professional

  • RHIA: Registered Health Information Administrator

  • RHIT: Registered Health Information Technician

  • UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.

Preferred Experience and Credentials:

  • Supervisory experience

Interested in learning more? Let’s talk about our EHR Trainer opportunities and your career growth!

What's the first thing that happens when one of the leading independent medical groups in the country comes together with a global leader in health care? Opportunity. With DaVita Medical Group, HealthCare Partners, The Everett Clinic, Northwest Physicians Network, MountainView Medical Group and Magan Medical Clinic joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. We're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.

Diversity creates a healthier atmosphere: Optum and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers 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. Optum and its affiliated medical practices is a drug-free workplace.

Candidates are required to pass a drug test before beginning employment.