Remote Coding Quality Analyst – National Healthcare Risk Adjustment Specialist with Full‑Time Telecommute Flexibility

Welcome to Episource – A Pioneer in Healthcare Innovation

At Episource, a proud member of the Optum family, we are redefining the way health plans and medical groups manage risk adjustment, compliance, and reimbursement. Our comprehensive end‑to‑end solutions empower providers to navigate the complexities of modern healthcare with confidence and efficiency. Founded on a culture of curiosity, collaboration, and social responsibility, we attract passionate professionals who want to make a tangible difference in the lives of patients and the broader community. If you are driven by a mission to improve health outcomes and enjoy the flexibility of a fully remote work environment, this is your opportunity to join a global, hybrid‑friendly team that values growth, innovation, and inclusion.

Position Overview: Remote Coding Quality Analyst – National Scope

As a Coding Quality Analyst, you will serve as a trusted resource for peers, performing meticulous over‑reads and peer‑to‑peer reviews of medical coding assignments. You will champion coding excellence across multiple projects, ensuring compliance with CMS guidelines, client‑specific protocols, and HCC documentation standards. This full‑time role (40 hours per week) offers a semi‑flexible schedule within standard business hours, with occasional overtime as business needs dictate. You will benefit from four weeks of intensive, on‑the‑job training and the freedom to work from any location within the United States.

Key Responsibilities

• Perform Peer‑to‑Peer Over‑Reads: Review medical records previously coded by colleagues to verify accuracy, completeness, specificity, and appropriateness of diagnosis codes in accordance with CMS and client‑specific guidelines for MRA and ACA coding.
• Vendor Oversight: Conduct quality assessments of vendor‑produced coding work, ensuring alignment with internal standards and regulatory requirements.
• Feedback Delivery: Prepare clear, actionable written feedback for coding staff and senior management, highlighting trends, root‑cause issues, and opportunities for improvement.
• Maintain Coding Currency: Keep up‑to‑date with ICD‑10‑CM, CPT, and HCPCS coding updates, as well as evolving Medicare Risk Adjustment HCC documentation requirements.
• Quality Improvement Participation: Actively contribute to process‑enhancement initiatives, leveraging data‑driven methodologies to drive efficiency and accuracy.
• Problem Solving & Collaboration: Lead collaborative problem‑solving sessions with cross‑functional teams, encouraging a culture of continuous learning and shared responsibility.
• Compliance & Data Security: Adhere strictly to PHI/PII handling policies, ensuring all work complies with company standards and regulatory mandates.
• Project Management: Organize and manage multiple priorities or projects simultaneously using appropriate tools and methodologies, meeting tight deadlines without sacrificing quality.
• Additional Duties: Take on other related responsibilities as assigned to support team objectives and organizational success.

Essential Qualifications

• High School Diploma or GED (required).
• Professional certification from AAPC and/or AHIMA (CPC, CCS, CRC, or CPMA).
• Minimum of 3 years of hands‑on HCC/Risk Adjustment coding experience.
• At least 1 year of coder‑based auditing experience, including peer‑to‑peer reviews.
• Demonstrated mastery of ICD‑10‑CM, CPT, and HCPCS coding systems.
• Solid understanding of coding compliance and reimbursement procedures for top Medicare Risk Adjustment HCCs.
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and collaboration platforms such as Microsoft Teams or Webex.
• Ability to complete a four‑week, full‑time training program (08:00 AM – 05:00 PM, Monday‑Friday) and transition to a flexible shift schedule thereafter.
• Willingness to work full‑time hours with occasional overtime as business needs arise.

Preferred Qualifications

• Direct experience conducting peer‑to‑peer reviews in a high‑volume coding environment.
• Advanced certifications (e.g., CCS‑P, CPMA) or additional training in risk adjustment analytics.
• Familiarity with quality‑management software or audit‑tracking tools.

Core Skills & Competencies

• Analytical Acumen: Ability to dissect complex medical documentation and translate it into precise coding decisions.
• Detail Orientation: Meticulous attention to detail ensures compliance with strict regulatory standards.
• Communication Excellence: Strong verbal and written communication skills for delivering feedback and interacting with stakeholders at all organizational levels.
• Independent Work Ethic: Proven ability to work autonomously, manage time effectively, and meet deadlines without constant supervision.
• Collaborative Spirit: Capability to foster strong relationships with peers, vendors, and leadership, encouraging a team‑first mindset.
• Ethical Integrity: High level of discretion and confidentiality when handling PHI/PII and proprietary information.
• Technical Proficiency: Comfort with virtual communication tools, secure file‑sharing platforms, and remote‑work technology.

Telecommuting Requirements & Work Environment

We believe that great talent thrives when given flexibility. As a remote employee, you will:

• Maintain a dedicated, private workspace separate from household distractions to protect information privacy.
• Ensure a reliable, UnitedHealth Group‑approved high‑speed internet connection for seamless access to secure systems.
• Secure all company‑sensitive documents, both physical and digital, in accordance with our Telecommuter Policy.
• Adhere to the UnitedHealth Group’s drug‑free workplace standards and complete pre‑employment drug testing.

Compensation, Benefits & Perks

While exact salary ranges depend on location, experience, and certifications, successful candidates can expect a competitive hourly rate (approximately $23.22 – $45.43) plus a comprehensive benefits suite:

• Medical, dental, and vision coverage with multiple plan options.
• Generous paid time off, holidays, and family leave policies.
• 401(k) retirement plan with company matching contributions.
• Equity stock purchase program and performance‑based incentive awards.
• Professional development assistance, including tuition reimbursement and certification support.
• Access to wellness programs, employee assistance resources, and mental‑health services.
• Recognition programs that celebrate high‑performing individuals and teams.

Career Growth & Learning Opportunities

At Episource, your career trajectory is shaped by your ambition and the support you receive. As a Coding Quality Analyst, you will:

• Participate in a structured onboarding experience that accelerates your expertise.
• Gain exposure to cutting‑edge risk‑adjustment technologies and analytics tools.
• Access mentorship from senior leaders in coding, compliance, and healthcare data.
• Explore lateral moves into roles such as Senior Auditor, Quality Management Lead, or Clinical Documentation Specialist.
• Prepare for future leadership positions through formal training programs and cross‑functional project assignments.

Our Culture – Inclusive, Innovative, Impact‑Driven

Our people are our greatest asset. We cultivate an environment where diversity of thought, background, and experience fuels creativity and better outcomes. Highlights of our culture include:

• Innovation Encouragement: Regular hackathons, idea‑sharing forums, and continuous‑learning circles keep us at the forefront of healthcare technology.
• Community Engagement: Volunteering initiatives and corporate social responsibility programs enable us to give back to the communities we serve.
• Employee Resource Groups (ERGs): Networks for under‑represented groups foster belonging and professional development.
• Transparent Communication: Open‑door policies and frequent town‑hall meetings ensure every voice is heard.

Application Process – Simple, Fast, and Transparent

Ready to embark on a rewarding remote career with Episource? Follow these easy steps:

1. Click the Apply To This Job button.
2. Complete the brief online application, uploading your resume, certifications, and a concise cover letter describing why you’re the perfect fit.
3. Participate in an initial phone screening with our talent acquisition team.
4. Engage in a technical interview focusing on coding scenarios, audit methodology, and problem‑solving approaches.
5. Attend a final discussion with the hiring manager to explore cultural fit and growth aspirations.

The posting will remain active for a minimum of two business days, or until we have built a robust candidate pool. Because we value your time, we aim to keep the hiring timeline efficient and communicative.

Why Join Episource?

Joining us means stepping into a role where every line of code you verify translates into better health outcomes for millions of patients. You’ll work alongside visionary professionals, enjoy the freedom of remote work, and receive the support needed to thrive both personally and professionally. If you are a detail‑oriented coder with a passion for quality and a desire to make a tangible impact, we encourage you to apply today.

Take the Next Step

Don’t let this opportunity pass you by. Click the link below, submit your application, and start your journey toward a fulfilling career with Episource, where innovation meets compassion.

Apply Now – Become a Remote Coding Quality Analyst