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Optum Clinical Auditor Jobs (NOW HIRING)

Community Health System

Coding Compliance Auditor

Fresno, CA · On-site

$44.52 - $56.65/hr

Experience performing medical record and billing audits/reviews, including clinical documentation ... Experience with 3M or Optum is preferred * Experience completing a formal validation report after ...

Community Health System

Coding Compliance Auditor

Fresno, CA · On-site

$44.52 - $56.65/hr

Experience performing medical record and billing audits/reviews, including clinical documentation ... Experience with 3M or Optum is preferred * Experience completing a formal validation report after ...

UnitedHealthcare

Clinical Claim Review | , |

Program Integrity Clinical Compliance Auditor Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care ...

divvyDOSE

Clinical Claim Review | , |

Program Integrity Clinical Compliance Auditor Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care ...

WhidbeyHealth

Coding Quality Auditor (RN)

Coupeville, WA · On-site

$95K - $133K/yr

Clinical documentation navigation * Abstracting workflows * Coding review processes * Utilize best-in-class coding and auditing technologies, including: * 3M Encoder / 360 Encompass * Optum CAC ...

WhidbeyHealth

Coding Quality Auditor (RN)

Coupeville, WA · On-site

$26.50 - $30/hr

Clinical documentation navigation * Abstracting workflows * Coding review processes * Utilize best-in-class coding and auditing technologies, including: * 3M Encoder / 360 Encompass * Optum CAC ...

Reliant Medical Group

Sr RN - Optum Infusion

Hollywood, FL · On-site

$33.75 - $44.75/hr

The primary role of the Senior RN is to provide clinical care and education to home-based patients ... auditing; plan of treatment oversight; and completion of nursing supervisory visits. Primary ...

UnitedHealth Group

Sr RN - Optum Infusion

Miramar, FL · On-site

$34.25 - $45.50/hr

The primary role of the Senior RN is to provide clinical care and education to home-based patients ... auditing; plan of treatment oversight; and completion of nursing supervisory visits. Primary ...

UnitedHealthcare

Sr RN - Optum Infusion

Hollywood, FL · On-site

The primary role of the Senior RN is to provide clinical care and education to home-based patients ... auditing; plan of treatment oversight; and completion of nursing supervisory visits. Primary ...

Scout Exchange

Coding Auditor, Facility

Clackamas, OR · On-site

$28.75 - $32.50/hr

Ability to understand the clinical content of the health record and abstract the data in the ... Utilizing the Code Base Charge Trigger system (CBCT) and OPTUM 360 EncoderPRO software system for ...

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Optum Clinical Auditor information

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$38.5K

$92.8K

$151K

How much do optum clinical auditor jobs pay per year?

As of Sep 11, 2026, the average yearly pay for optum clinical auditor in the United States is $92,797.00, according to ZipRecruiter salary data. Most workers in this role earn between $72,000.00 and $112,000.00 per year, depending on experience, location, and employer.

What does an Optum Clinical Auditor do?

An Optum Clinical Auditor is responsible for reviewing medical records, claims, and billing data to ensure accuracy and compliance with healthcare regulations and company policies. They analyze clinical documentation to verify that services billed are supported and appropriately coded. Clinical Auditors at Optum also identify areas for improvement, provide feedback to healthcare providers, and help prevent fraud, waste, and abuse in the healthcare system.

What are the key skills and qualifications needed to thrive as an Optum Clinical Auditor?

To thrive as an Optum Clinical Auditor, you need a solid background in healthcare, clinical documentation, coding (such as ICD-10 and CPT), and relevant auditing experience, often supported by certifications like CPC, CCS, or RN licensure. Familiarity with medical record review systems, claims processing platforms, and auditing software is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for interpreting data and collaborating with providers. These skills ensure accurate audit results, regulatory compliance, and improved healthcare outcomes through thorough and precise clinical assessments.

How does an Optum Clinical Auditor collaborate with healthcare providers to ensure accurate and compliant medical documentation?

As an Optum Clinical Auditor, you will frequently interact with healthcare providers to review and clarify medical records, ensuring they meet regulatory and payer requirements. This collaboration may involve virtual meetings, written feedback, and ongoing education to improve documentation practices. Building strong relationships with providers is essential, as it helps foster open communication and ensures compliance standards are consistently met. Working within a multidisciplinary team, you'll also collaborate with coding specialists and compliance officers to address complex cases and stay current on evolving industry guidelines.

What are popular job titles related to Optum Clinical Auditor jobs?

For Optum Clinical Auditor jobs, the most frequently searched job titles are:

Infographic showing various Optum Clinical Auditor job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 74% Full Time, 15% Part Time, and 8% Contract. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution, with an average salary of $92,797 per year, or $44.6 per hour.

Outpatient Coding Auditor - Surgical Specialty

Gulfport, FL • On-site

Sage Clinical RCM, LLC
See more jobs at Sage Clinical RCM, LLCexternal

$26 - $29.50/hr

Full-time

Re-posted 6 days ago

Job description

Description:

 Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding. This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands-on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff.  


Key Responsibilities 

  • Perform audits of outpatient surgical encounters, including operative reports and related documentation 
  • Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs 
  • Ensure compliance with CMS, payer, and official coding guidelines 
  • Identify trends, risks, and educational opportunities based on audit findings 
  • Provide written audit feedback and coding education to support quality improvement 
  • Collaborate with coding leadership and quality teams to address identified issues 
  • Maintain required productivity, accuracy, and turnaround standards 
Requirements:

  Required Qualifications 

  • 3+ years of outpatient coding audit experience with a focus on surgical specialties 
  • Strong knowledge of CPT (Surgery section), ICD-10-CM, and modifier usage 
  • Experience auditing operative reports and post-operative documentation 
  • Familiarity with CMS guidelines, NCCI edits, and payer-specific rules 
  • Ability to clearly document audit findings and recommendations 
  • High attention to detail and strong analytical skills 

Preferred 

  • Experience auditing high-volume surgical specialties such as orthopedics, general surgery, ENT, GI, or OB/GYN 
  • Prior experience supporting internal or external audits, quality initiatives, or education programs 
  • Familiarity with Epic, 3M, Optum, TruCode, or similar coding tools 
  • CPC, CCS, or equivalent credential (active and in good standing)