APR-DRG CVA RN Auditor - National Remote
Posted 2025-08-23
Remote, USA
Full Time
Immediate Start
<p style="font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><strong style="font-weight: bold;">$10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS</strong></span></span></span></p>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team 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 make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start <b style="font-weight: bold;">Caring. Connecting. Growing together</b>. <o:p></o:p></span></span></span></p>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">In this position as a <strong>DRG CVA RN Auditor</strong>, you will apply your expert knowledge of the MS-DRG and APR-DRG coding/reimbursement methodology systems, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines in the auditing of inpatient claims. Employing both industry and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals to identify overpayments. Utilizing excellent communications skills, you will compose rationales supporting your audit findings.<o:p></o:p></span></span></span></p>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. <o:p></o:p></span></span></span></p>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Primary Responsibilities:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Conduct MS-DRG and APR-DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification</span> <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Utilize expert knowledge to identify the ICD-10-CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD-10 Official Guidelines for Coding and Reporting, and AHA Coding Clinic guidance <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Apply current ICD-10 Official Coding Guidelines and AHA Coding Clinic citations and demonstrate working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing</span> <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Utilize solid command of anatomy and physiology, diagnostic procedures, and surgical operations developed from specialized training and extensive experience with ICD-10-PCS code assignment <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Write clear, accurate and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines, and AHA Coding Clinics <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Utilize proprietary workflow systems and encoder tool efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, and client processes and requirements <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Maintain and manage daily case review assignments, with a high emphasis on quality</span> <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Provide clinical support and expertise to the other investigative and analytical areas</span> <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Work in a high-volume production environment that is matrix driven</span> <o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Medical Plan options along with participation in a Health Spending Account or a Health Saving account<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">401(k) Savings Plan, Employee Stock Purchase Plan<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Education Reimbursement<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Employee Discounts<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Employee Assistance Program<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Employee Referral Bonus Program<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">More information can be downloaded at: <a href="http://uhg.hr/uhgbenefits" style="color: rgb(4, 95, 171); text-decoration: none; line-height: inherit;">http://uhg.hr/uhgbenefits</a><o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">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.</span></span></span></p><br><br><p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Required Qualifications:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Associate’s degree (or higher)<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Unrestricted RN (Registered Nurse) license<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">CCS/CIC or willing to obtain certification within 6 months of hire<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">3+ years of MS DRG/APR DRG coding experience in a hospital environment with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">2+ years of ICD-10-CM coding experience including but not limited to expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM)<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">2+ years of ICD-10-PCS coding experience including but not limited to expert knowledge of the structural components of PCS such as selection of appropriate body systems, root operations, body parts, approaches, devices, and qualifiers<o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Preferred Qualifications:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience with prior DRG concurrent and/or retrospective overpayment identification audits<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience working with Utilization Management</span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience with readmission reviews of claims<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience with DRG encoder tools (ex. 3M)<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Healthcare claims experience<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Managed care experience<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Knowledge of health insurance business, industry terminology, and regulatory guidelines<o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Soft Skills:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Ability to use a Windows PC with the ability to utilize multiple applications at the same time<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Ability to work independently in a remote environment and deliver exceptional results<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Demonstrate excellent written and verbal communication skills, solid analytical skills, and attention to detail</span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Excellent time management and work prioritization skills<o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Physical Requirements and Work Environment:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Have a secluded office area in which to perform job duties during the work day<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Have reliable high - speed internet access and a work environment free from distractions </span></span></span></li>
</ul>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.<o:p></o:p> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> </span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;">The salary range for this role is $</span></span><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;">34.42</span></span><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;"> to $</span></span><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;">67.60</span></span><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;"> per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.</span></span><span class="EOP SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px;"> </span></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> </span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;"><i>Application Deadline: </i></b><i>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.</i> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><i>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.</i><o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;"> </b><o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><i>Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.</i><o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><i>UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.</i><o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="line-height: 10.7px;">#RPO #GREEN</span></span></span></span></p>
<p style="margin: 0px 0px 13px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"></span></span></span></p>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team 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 make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start <b style="font-weight: bold;">Caring. Connecting. Growing together</b>. <o:p></o:p></span></span></span></p>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">In this position as a <strong>DRG CVA RN Auditor</strong>, you will apply your expert knowledge of the MS-DRG and APR-DRG coding/reimbursement methodology systems, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines in the auditing of inpatient claims. Employing both industry and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals to identify overpayments. Utilizing excellent communications skills, you will compose rationales supporting your audit findings.<o:p></o:p></span></span></span></p>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. <o:p></o:p></span></span></span></p>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Primary Responsibilities:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Conduct MS-DRG and APR-DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification</span> <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Utilize expert knowledge to identify the ICD-10-CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD-10 Official Guidelines for Coding and Reporting, and AHA Coding Clinic guidance <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Apply current ICD-10 Official Coding Guidelines and AHA Coding Clinic citations and demonstrate working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing</span> <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Utilize solid command of anatomy and physiology, diagnostic procedures, and surgical operations developed from specialized training and extensive experience with ICD-10-PCS code assignment <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Write clear, accurate and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines, and AHA Coding Clinics <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Utilize proprietary workflow systems and encoder tool efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, and client processes and requirements <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Maintain and manage daily case review assignments, with a high emphasis on quality</span> <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Provide clinical support and expertise to the other investigative and analytical areas</span> <o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="background: white;">Work in a high-volume production environment that is matrix driven</span> <o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Medical Plan options along with participation in a Health Spending Account or a Health Saving account<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">401(k) Savings Plan, Employee Stock Purchase Plan<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Education Reimbursement<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Employee Discounts<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Employee Assistance Program<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Employee Referral Bonus Program<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">More information can be downloaded at: <a href="http://uhg.hr/uhgbenefits" style="color: rgb(4, 95, 171); text-decoration: none; line-height: inherit;">http://uhg.hr/uhgbenefits</a><o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">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.</span></span></span></p><br><br><p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Required Qualifications:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Associate’s degree (or higher)<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Unrestricted RN (Registered Nurse) license<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">CCS/CIC or willing to obtain certification within 6 months of hire<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">3+ years of MS DRG/APR DRG coding experience in a hospital environment with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">2+ years of ICD-10-CM coding experience including but not limited to expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM)<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">2+ years of ICD-10-PCS coding experience including but not limited to expert knowledge of the structural components of PCS such as selection of appropriate body systems, root operations, body parts, approaches, devices, and qualifiers<o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Preferred Qualifications:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience with prior DRG concurrent and/or retrospective overpayment identification audits<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience working with Utilization Management</span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience with readmission reviews of claims<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience with DRG encoder tools (ex. 3M)<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Healthcare claims experience<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Managed care experience<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Knowledge of health insurance business, industry terminology, and regulatory guidelines<o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Soft Skills:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Ability to use a Windows PC with the ability to utilize multiple applications at the same time<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Ability to work independently in a remote environment and deliver exceptional results<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Demonstrate excellent written and verbal communication skills, solid analytical skills, and attention to detail</span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Excellent time management and work prioritization skills<o:p></o:p></span></span></span></li>
</ul>
<p style="font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;">Physical Requirements and Work Environment:</b><o:p></o:p></span></span></span></p>
<ul>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Have a secluded office area in which to perform job duties during the work day<o:p></o:p></span></span></span></li>
<li style="font-family: Tahoma; color: rgb(0, 0, 0);"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Have reliable high - speed internet access and a work environment free from distractions </span></span></span></li>
</ul>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.<o:p></o:p> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> </span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;">The salary range for this role is $</span></span><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;">34.42</span></span><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;"> to $</span></span><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;">67.60</span></span><span data-contrast="auto" class="TextRun SCXO100370953 BCX0" xml:lang="EN-US" lang="EN-US" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px; font-variant-ligatures: none !important;"><span class="NormalTextRun SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; background-color: inherit;"> per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.</span></span><span class="EOP SCXO100370953 BCX0" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); line-height: 19.55px;"> </span></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;">Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> </span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;"><i>Application Deadline: </i></b><i>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.</i> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><i>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.</i><o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><b style="font-weight: bold;"> </b><o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><i>Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.</i><o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma; text-align: center;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><i>UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.</i><o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> <o:p></o:p></span></span></span></p>
<p style="margin: 0px 0px 12px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"><span style="line-height: 10.7px;">#RPO #GREEN</span></span></span></span></p>
<p style="margin: 0px 0px 13px; color: rgb(0, 0, 0); font-size: 13.02px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255); font-family: Tahoma;"><span style="color: #000000;"><span style="font-size: 10px;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"></span></span></span></p>