Job Title: Quality Assurance Specialist
Requisition Number: 2307007
Job Category: Medical & Clinical Operations
Location: Chennai, Tamil Nadu, India
About Optum
Optum is a global organization that leverages technology and innovation to deliver care and help millions of people live healthier lives. By joining our team, you will directly contribute to improved health outcomes by connecting people with the right care, pharmacy benefits, data, and resources.
We offer:
A culture guided by inclusion and collaboration
Opportunities for career development and growth
Comprehensive benefits
A chance to make an impact on the communities we serve
Our Mission: Caring. Connecting. Growing together.
Primary Responsibilities
Perform QA audits across multiple projects.
Develop effective QA sampling and audit methodologies for assigned projects.
Monitor and measure quality trends in coding projects using analytical skills.
Conduct root cause analysis, identify knowledge gaps, and provide team training.
Review scope documents and guidelines for new clients before project initiation.
Lead pilot project delivery to meet client SLA on quality.
Review and customize standard coding guidelines as per client needs.
Identify error trends from client feedback and drive continuous improvement.
Conduct training on audit protocols, comment matrix, and best practices for auditors.
Provide responses to internal coding queries with proper rationale.
Ensure compliance with internal and external coding standards.
Adhere to employment terms, policies, and directives, including reassignments, work shifts, and flexible arrangements as business needs evolve.
Required Qualifications
Education: Degree in Life Sciences or Medical/Paramedical Sciences
Certification: Valid AAPC or AHIMA certification (mandatory)
Experience: Minimum 3+ years in HCC Risk Adjustment Coding
Knowledge & Skills:
Expertise in risk adjustment models (Medicare & Commercial)
Proficiency in ICD-10-CM guidelines, AHA coding clinic updates, and client-specific requirements
Commitment to Diversity & Equity
At UnitedHealth Group, we believe everyone deserves access to better health—regardless of race, gender, sexuality, age, income, or location. We are dedicated to addressing health disparities, promoting equity, and reducing barriers to care. Additionally, we are committed to minimizing our environmental impact while improving global health outcomes.
Gujarat :
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Pondicherry (Puducherry) |Jharkhand :
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Siliguri |Illinois :
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Appleton | Kenosha | Pleasant Prairie | Portage | Waukesha |United states :
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Netherlands |Remote Australia :
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Queensland |Melbourne :
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England | Harlow | Leeds | London | Maidenhead | Salt Lake City | Stevenage | Stirling | United Kingdom |North Yorkshire :
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Sheffield |Oxfordshire :
Witney |Ontario :
Uxbridge | North York | Richmond Hill | Renfrew | Mississauga | Australia |Canada :
Canada |Quebec :
Montreal |Brussels :
Brussels |Antwerp :
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Argentina | Peru |Brazil :
Brazil | Sao paulo |Attica :
Athens | Koropi |Greece :
Greece |North Island :
Auckland |New Zealand :
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Madrid |Cebu Province :
Cebu City |Philippines :
Manila |Croatia :
Croatia |Zagreb :
Zagreb |Estonia :
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Tallinn |Hà Nội :
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Japan | Saitama |Tokyo :
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