[Hiring] Audit and Recovery Analyst @UnitedHealth Group

Role Description

The Audit & Recovery Analyst position is to participate with the audit and recovery team in the timely implementation and completion of audit initiatives, and the related activities. Analyze, evaluate, and perform timely audits based on Optum policies and consistent with the nationally published guidelines regarding procedural documentation. Address provider calls regarding the audit process. Strong decision-making skills involving medical record documentation and minimum medical record documentation requirements.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Maintain understanding of procedural codes and the documentation required to verify services and substantiate payment.
• Assist in the development and implementation audit and the related activities including printing and preparing letters requesting medical records, completion of the prepared audits and processing and completing appeals of adverse determinations of payment.
• Perform other projects, tasks and duties as assigned by management, professional committees and/or facilitate said processes.
• Ability to interface with supporting departments regarding the implementation of audit and recovery issues such as committee activities, appeals and changes in clinical submission.
• Participation in policy development.
• Field questions from providers regarding the purpose and right of Optum Physical Health Solutions in conducting medical records audit.
• Ability to solve problems and deal with a variety of specific variations in situations where only limited standardization exists.
• Become familiar with the interaction with ODAR and completing the appeals of overpayment determinations.
• Demonstrate effective written and oral communication skills.
• Maintain positive and productive relationships with provider community, clinical staff, and all other personnel.
• Accurately record all verbal communications with providers into communication log database.
• Interact with audit and recovery staff in the completion of audit related activities.
• Effectively present information and respond to questions from providers, audit and recovery staff, management, and other employees.
• Working knowledge of various software applications to perform the requirements of the position.

Qualifications

• Undergraduate degree in specialized Physical medicine from an accredited college or university.
• Current Licensed or Certified Physical Therapist or Chiropractor with state-licensing agency.

Requirements

• Clinical practice experience.
• Thorough detailed working knowledge of procedural coding and the required supporting documentation.
• Proven solid decision-making skills involving clinical and administrative data.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).

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.