Behavioral Health Coding Quality Analyst at Boise

Job Description

Special Investigations Unit (SIU) Medical Coding Quality AnalystThe OptumHealth Behavioral Solutions (OHBS) SIU Medical Coding Quality Analystis responsible for coding and auditing services specific to administrative fraud, waste and abuse cases. This includes the analysis, documentation, explanation and translation of medical and behavioral diagnosis and procedures. The Medical Coder/Analyst will support the OHBS SIU in research, issues and inquires that relate to their reviews and SIU policies on Medical Coding/Auditing. Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent, utilizing most current reference materials to include, but not limited to: Current Procedural Terminology (CPT), Internal Classification of Disease (ICD-9/ICD-10) and Healthcare Common Procedure Coding System (HCPCs) guidelines. Documents Decisions on reviews through notations and enters notes in appropriate company systems. Ability to discuss and present on decisions made to appropriate internal and external individuals/groups. Coordinate with team members to understand trends and schemes related to billing issues/coding trends.

Job Requirements

3+ years ofexperience in codingand medical billing Associates degree or related field experience Clinical and/or coding expertise in a Physician office, SNF, ALF, Hospital setting, and/or billing/officeStrong oral and written communication skills Strong organizational/time management skills and be able to work independently or as a team Strong knowledge of CMS 1500 and UB04 data elements Strong knowledge of ICD, CPT, HCPC and Revenue Codes Problem solving skills Ability to support heavy work load volume and meet unit standards while engaging multiple priorities Serves as a resource on moderately complex issues related to coding / billing Current CPC Certification OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.At OptumHealth, you will perform within an innovative culture thats focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact thats greater than youve ever imagined.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Country: USA, State: Idaho, City: Boise, Company: UnitedHealth Group.