Job Title: Coding Quality Analyst
Requisition Number: 2305060
Job Category: Medical & Clinical Operations
Primary Location: Plymouth, MN, US (Remote considered)
Business Segment: Optum
Employee Status: Regular
Job Level: Individual Contributor
Travel: No
Overtime Status: Non-exempt
Schedule: Full-time (40 hours/week)
Shift: Day Job (Flexible 8-hour schedules between 8am–5pm CST; occasional overtime as needed)
Telecommuter Position: Yes
About Optum
Optum is a global healthcare organization that delivers care through technology, connecting people with the resources, pharmacy benefits, and data they need to live healthier lives. The organization emphasizes inclusion, career development, and comprehensive benefits.
Role Summary
The Coding Quality Analyst ensures the accuracy of medical coding and audits records for compliance, fraud, waste, or abuse. The role requires application of CPT, ICD-9/10, and HCPCS guidelines, strong attention to detail, and the ability to work independently or in a team. Telecommuting is supported.
Primary Responsibilities
Conduct reviews of suspicious or potentially fraudulent records using CPT, ICD-9/10, and HCPCS guidelines.
Document review decisions through system notations.
Present and discuss decisions with internal and external stakeholders.
Collaborate with team members to identify trends or schemes in billing and coding practices.
Complete 4 weeks of on-the-job training with schedule aligned to employee availability.
Required Qualifications
High School Diploma/GED or higher.
Active and unrestricted coding certification from AHIMA (CCS, CCS-P, or RHIT) or AAPC (CPC).
2+ years of CPT coding experience.
2+ years of medical record auditing experience.
Flexibility to work 40 hours/week and any of the 8-hour shifts within 8am–5pm CST; occasional overtime may be required.
Must be 18 years of age or older.
Preferred Qualifications
Behavioral health experience.
Experience with fraud, waste, abuse, and error detection.
Knowledge of CMS 1500 and UB04 data elements.
Familiarity with Encoder Pro software.
Telecommuting Requirements
Maintain security of company-sensitive documents.
Dedicated workspace separated from living areas for information privacy.
High-speed internet connection approved by UnitedHealth Group.
Soft Skills
Strong oral and written communication skills.
Excellent organizational and time management skills.
Ability to work independently or as part of a team.
Ability to manage multiple priorities while meeting production standards.
Compensation & Benefits
Hourly pay: $23.41–$41.83 (full-time basis).
Comprehensive benefits package including incentives, recognition programs, equity stock purchase, and 401k contribution (eligibility applies).
Compliance & Equal Opportunity
Adhere to UnitedHealth Group Telecommuter Policy.
Equal employment opportunity regardless of race, religion, gender, sexual orientation, disability, or veteran status.
Drug-free workplace; pre-employment drug test required.
Mission & Values
UnitedHealth Group is committed to equitable healthcare, reducing disparities, and improving health outcomes while mitigating environmental impact.
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