C&S Clinical Coding Analyst

We need to produce HTML fragment with sections: About the role? The posting includes intro paragraphs about Optum, culture, etc. That could be "About the role" or maybe "About the company". The instruction: use

for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). Use

• for any list of duties/requirements/benefits, and

  for prose. Do NOT repeat the job title as a heading (the page already shows it) and do NOT put Job ID / requisition numbers as headings — fold minor metadata into a short

  or drop it. Preserve ALL substantive information; do NOT invent or summarize away detail. Remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. IMPORTANT: include a section ONLY when the posting has real, specific content for it — never emit a heading followed by filler/placeholder text (e.g. "commensurate with experience", "not specified", "N/A", "varies", "TBD") and never create Pay/Schedule/Benefits sections unless the posting actually states them. Prefer a few substantive sections over many thin ones. Output ONLY the HTML fragment — no /, no markdown code fences. We need to extract substantive content: The posting includes: - Intro about Optum: "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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together." - Then description of role: "The C&S Coding Clinical Analyst is required to determine the accuracy of claims submitted by a provider to UnitedHealth Group by comparing it to the medical record(s) submitted for the date(s) of service being reviewed. They must be able to exercise judgement/decision making on complex payment decisions that directly impacts the provider and UHC/Client by following state and government compliance guidelines, coding requirements and policies. They must confidently analyze and interpret data and medical records/documentation on a daily basis to understand historical claims activity, determine validity and demonstrate their ability to provide written communication to the provider. They are responsible to investigate, review and provide clinical and/or coding expertise in a review of pre-payment claims. They need to effectively manage their caseload and monthly metrics in a production driven environment and ensure they are meeting all compliance turnaround times mandated by the client. The Senior Recovery Resolution Analyst must be proficient in computer skills and able to navigate multiple systems at one time with varying levels of complexity. They must have the ability to research and work independently on making decisions on complex cases. Remote: You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges." - Then "Responsibilities" list: bullet points (starting with "Performs quality audits..."). - Then "You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in." - Then "Required Qualifications" list. - Then "Preferred Qualifications" list. - Then "Soft Skills Physical Requirements and Work Environment: frequent speaking, listening using headset, sitting, use of hands/fingers across keyboard Must be proficient and able to navigate and maneuver multiple systems at one time with varying levels of complexity Highly organized with effective and persuasive communication skills Strong written communication skills Open to change and new information; ability to adapt in changing environments and integrate best practices" - Then "All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy." - Then "Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24.00 to $43.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable." - Then "Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records." - Then "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." - Then mission statement etc. That's boilerplate EEO etc. Should be removed. We need to remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. So we should remove the mission statement, EEO, drug-free workplace, etc. Also remove "Application Deadline:" maybe considered application instructions? The instruction says remove application instructions. So we should drop the "Application Deadline:" line. Also drop "Pursuant to the San Francisco Fair Chance Ordinance..." maybe considered EEO? It's a legal statement; we should remove. We need to keep substantive info: Intro about Optum and culture, role description, responsibilities list, reward/recognition sentence, required qualifications list, preferred qualifications list, soft skills/physical requirements, telecommuter policy note, pay and benefits info. We need to decide sections: Could have "About the role" (intro + role description), "Responsibilities", "Required Qualifications", "Preferred Qualifications", "Skills" (maybe soft skills), "Benefits", "Pay". The instruction says prefer a few substantive sections over many thin ones. Could combine some. We need to use

  for section headings. Use

  • for any list of duties/requirements/benefits, and

    for prose. We must not repeat job title as heading. So we won't put "C&S Coding Clinical Analyst" as heading. We need to preserve all substantive info; do not invent or summarize away detail. So we need to keep the exact phrasing? Probably we can keep the sentences as is, but we can format. We need to avoid filler like "commensurate with experience". Not present. We need to not create Pay/Schedule/Benefits sections unless posting actually states them. It does state pay range and benefits, so we can include Pay and Benefits sections. Schedule: Not mentioned besides remote telecommute flexibility. Could be considered schedule? Not explicit. So we should not create Schedule section. Now, we need to decide what goes into each section. Potential sections: - About the role (or About the company): include the intro paragraphs about Optum, culture, and the role description (the paragraph about C&S Coding Clinical Analyst and Senior Recovery Resolution Analyst, remote flexibility). Could be one

    or multiple

    . - Responsibilities: list the bullet points under "Responsibilities". Those are a series of sentences each starting with a verb. We'll put each as

  • . - Required Qualifications: list the bullet points under "Required Qualifications". Each line is a qualification. We'll put as
  • . - Preferred Qualifications: list bullet points under "Preferred Qualifications". We'll put as
  • . - Skills: maybe combine "Soft Skills Physical Requirements and Work Environment" and also the telecommuter policy note? Could be a section "Skills and Work Environment". We'll put as
    • for each bullet. - Benefits: list benefits mentioned: comprehensive benefits package, incentive and recognition programs, equity stock purchase, 401k contribution. Also mention "far-reaching choice of benefits and incentives". We'll put as
      • . - Pay: mention hourly pay range $24.00 to $43.00 per hour based on full-time employment, plus note that pay based on factors, comply with minimum wage laws. We'll put as

        . We need to ensure we don't include filler like "all benefits are subject to eligibility requirements". That's substantive, we can keep. We need to remove duplicated lines: there may be duplicates like "You'll be rewarded and recognized..." appears only once. We need to remove application instructions: we removed "Application Deadline:" line. We need to remove legal/EEO boilerplate: we removed mission statement, EEO, drug-free workplace, etc. Now, we need to output only HTML fragment, no /, no markdown fences. Let's craft. First, maybe start with

        About the role

        then

        ...

        . We need to include the intro about Optum and culture, plus role description. Let's combine: 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The C&S Coding Clinical Analyst is required to determine the accuracy of claims submitted by a provider to UnitedHealth Group by comparing it to the medical record(s) submitted for the date(s) of service being reviewed. They must be able to exercise judgement/decision making on complex payment decisions that directly impacts the provider and UHC/Client by following state and government compliance guidelines, coding requirements and policies. They must confidently analyze and interpret data and medical records/documentation on a daily basis to understand historical claims activity, determine validity and demonstrate their ability to provide written communication to the provider. They are responsible to investigate, review and provide clinical and/or coding expertise in a review of pre-payment claims. They need to effectively manage their caseload and monthly metrics in a production driven environment and ensure they are meeting all compliance turnaround times mandated by the client. The Senior Recovery Resolution Analyst must be proficient in computer skills and able to navigate multiple systems at one time with varying levels of complexity. They must have the ability to research and work independently on making decisions on complex cases. Remote: You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. That seems good. Now Responsibilities: list each bullet. From the text: "Performs quality audits of clinical review cases of CPT, HCPCS, and modifiers assigned to codes on claims in a telecommuting work environment" "Determines accuracy of medical coding/billing and payment recommendation for pre-payment claims" "This could include Medical Director/physician consultations, interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies and consideration of relevant clinical information" "Determines appropriate level of service utilizing Evaluation and Management coding principles" "Ensures adherence to state and federal compliance policies, reimbursement policies and contract compliance" "Identifies aberrant billing patterns and trends, evidence of fraud, waste or abuse, and recommends providers to be flagged for review" "Maintains and manages daily case review assignments, with accountability to quality, utilization and productivity standards" "Provides clinical support and expertise to the other investigative and analytical areas" "Participates in team and department meetings" "Engages in a collaborative work environment when applicable but is also able to work independently" "Serves as a clinical resource to other areas within the clinical investigative team" "Work with applicable business partners to obtain additional information relevant to the clinical review" We'll put each as
      • . Now Required Qualifications list: "High School Diploma/GED" "Certified Coder AHIMA or AAPC Certified