Outpatient Facility Auditor
UnitedHealth Group
- Phoenix, Arizona, United States
- Phoenix, Arizona, United States
About
Performs all necessary duties related to the Outpatient Audit process including:
Maintain a dedicated HIPAA-compliant home office space with access to high speed cable internet available
Review of outpatient hospital and ambulatory surgery centers medical records all associated documentation to determine the accuracy and appropriateness of outpatient coding and billing practices
Create audit summary documentation
Enter status and results into Claim Reviewer system
Responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally, verbally or in writing
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:
High School Diploma / GED
Must have one of the following coding certifications: CPC, COC, CCS, OR CCS - P with designation from AHIMA OR AAPC
Must be 18 years of age OR older
2+ years of experience with medical code auditing in an outpatient facility (hospital and / or ASC (ambulatory surgery center)
Advanced knowledge in CPT / HCPCS coding and National Correct Coding Initiative (NCCI) edit review / resolution
Proficient in PC Windows environment
Ability to work any of our full time (40 hours / week), 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm from Monday - Friday, including the flexibility to work occasional overtime or weekends given the business need
Preferred Qualifications:
RN, RHIT, OR RHIA with a coding credential
Experience with defending insurance company hospital outpatient coding denials and coding auditing experience
Understanding of 3M Encoder / grouper logic
Understanding of commercial insurance reimbursement
Competency in APC payment classification
Telecommuting Requirements:
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
Ability to apply complex procedures requiring judgment
Competency in oral and written communications particularly in the area of conflict resolution; ability to identify, define and explain day-to-day problems and solutions
Direct, but moderately supervised, impact on quality and efficiency of services OR operation of company OR revenues / expenses
Impact on quality and efficiency of services or operation of company
Ability to organize complex tasks and analyze complex issues
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 - $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Languages
- English
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