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Coding Quality Analyst - National Remote

Remote, USA Full-time Posted 2026-06-30

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The OptumHealth Behavioral Solutions (OHBS) PNI Coding Quality Analyst is 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 reputed company/Analyst will support the OHBS PNI in research, issues and inquires that relate to their reviews and policies on Medical Coding/Auditing. This position is full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6am - 6pm. It may be necessary, given the business need, to work occasional overtime. We offer 2 weeks of on-the-job training followed by a 90 day reputed company up period. The hours of the training will be based on schedule or will be discussed on your first day of employment. You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: • Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent, utilizing most reputed company reference materials to include, but not limited to: reputed company 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 reputed company to billing issues/coding trends 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 • Certified reputed company reputed company (reputed company, reputed company-P, RHIT) or reputed company Certified reputed company (CPC) • Must be 18 years of age OR older • 3 years of coding experience in CPT medical coding / auditing or coding review for quality assurance • Ability to work full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6am - 6pm. It may be necessary, given the business need, to work occasional overtime. Preferred Qualifications: • Behavioral Health experience • Knowledge of CMS 1500 and UB04 data elements • Encoder Pro familiarity Telecommuting Requirements: • Ability to reputed company reputed company 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 reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service. Soft Skills: • Strong oral and written communication skills • Strong organizational/time management skills and be able to work independently or as a team • Ability to meet production unit standards while engaging in multiple priorities • Problem solving skills • reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, reputed company, Rhode reputed company, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $23.22 to $45.43 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. 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 reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company 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 reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO Apply Job!

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