Are you a seasoned professional in healthcare coding and quality assurance? Optum, a leading provider of health services, is hiring Certified Quality Assurance Specialists in Chennai. This role offers a chance to dive deep into risk adjustment models for Medicare and Commercial lines, ensuring top-tier accuracy in medical coding. If you’re passionate about improving healthcare outcomes through meticulous QA audits and training, this position could be your next career milestone. Discover how you can contribute to a team dedicated to excellence in medical risk adjustment coding.
Key Responsibilities
As a Certified Quality Assurance Specialist at Optum, you’ll play a pivotal role in maintaining high standards in healthcare coding. Your duties will include:
- Applying in-depth knowledge of Medicare and Commercial risk adjustment models to ensure precise coding.
- Mastering ICD-10-CM guidelines, AHA coding clinic updates, and client-specific requirements for accurate audits.
- Conducting QA audits across multiple projects, developing effective sampling methodologies, and analyzing quality trends.
- Performing root cause analysis to identify gaps, followed by targeted training for project teams.
- Reviewing scope documents and guidelines for new clients, leading pilot projects to meet SLA quality standards.
- Customizing coding guidelines, addressing error trends from client feedback, and driving continuous improvements.
- Delivering training on audit protocols, comment matrices, and best practices for auditors.
- Responding to internal coding queries with solid rationale and adhering to compliance standards.
Qualifications and Requirements
To thrive in this Certified Quality Assurance Specialist role, you’ll need:
- A degree in Life Sciences or Medical/Paramedical Sciences.
- Minimum 3+ years of experience in HCC Risk Adjustment Coding, plus 6 months in Quality Sampling and Auditing.
- Valid AAPC or AHIMA certification.
- Strong analytical skills for monitoring coding quality and trends.
- Proficiency in risk adjustment models, ICD-10-CM, and QA methodologies.
Benefits of Joining Optum
Optum offers a competitive package for Certified Quality Assurance Specialists, including:
- Attractive salary ranging from INR 8-15 LPA, based on experience.
- Comprehensive health and wellness benefits, including medical insurance.
- Opportunities for professional growth through training and certifications.
- Work-life balance with flexible hours and remote options.
- A collaborative environment focused on innovation in healthcare quality assurance.
How to Apply
Interested candidates should send their updated resumes to Ashraff Shaik at ashraffshaik.mohammad@optum.com. Highlight your experience in risk adjustment coding and QA audits to stand out. Applications are reviewed on a rolling basis, so apply soon!