Optum · 3 hours ago
Coding Quality Analyst
United States
Full-time
Remote
Mid Level
$28.94/hr - $51.83/hr
3+ years expOptum, in partnership with ProHealth Care, is seeking a Coding Quality Analyst to support high-quality care delivery in the community. The role involves serving as a liaison between coding teams and providers, providing education and guidance on coding compliance, and conducting audits to ensure accuracy in documentation and coding practices.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Serve as a liaison between coding teams and providers, delivering expert guidance to resolve inquiries and concerns
Collaborate with Edits and Denials teams to analyze trends and implement educational initiatives or system edits to address recurring issues
Partner with clinical leadership during the introduction of new services to ensure accurate documentation and coding compliance
Participate in specialty and physician group meetings on a quarterly basis to provide targeted coding education and respond to ad hoc inquiries
Deliver comprehensive coding and documentation training for all newly onboard providers
Provide annual education to providers with on code set updates to maintain compliance and accuracy
Conduct annual provider audits to validate charges and support documentation, while identifying potential revenue opportunities
Provide targeted education and follow-up audits for providers who do not meet established quality standards
Perform ad hoc audits in response to client requests or identified concerns
Educate coders and providers on audit findings and emerging trends to promote continuous improvement
Assist coders and/or supervisors as needed on rebuttals for tri-annual audits
Qualification
Required
High School Diploma/GED (or higher)
Professional coder certification with credentialing from AHIMA and/or AAPC (CPC, CCS-P, RHIA, RHIT) to be maintained annually
3+ years of Physician medical coding (ICD-10, CPT, HCPCS II) experience in a multi-specialty physician clinic
2+ years of experience with Residency Program (teaching hospital) with coding experience in complex procedures in one or more the following specialty areas: Primary Care, GI, General Surgery, Colorectal, Endovascular, Internal Med, Family Med, Pediatrics, Urgent Care
2+ years of experience being able to provide expert level coding guidance to physicians, practitioners, and coders as needed
Intermediate level of knowledge of MUE and NCCI classification and reimbursement structures
Intermediate level of proficiency in a Windows PC environment, including MS Excel and with Epic
Preferred
Experience auditing charts in a professional coding environment
Experience providing physician/coding education a plus
Experience with various systems (Microsoft Teams, Encoder Pro, etc.)
Experience in Inpatient/Observation E/M coding
Intermediate level of experience with Microsoft Excel
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
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