Senior Business Analyst PB Revenue Integrity – Remote

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.

Under limited supervision by the Manager, Revenue Integrity, this position is responsible for supporting our professional billing services. for compliant billing including, but not limited to, denial analysis, reimbursement analysis with monitoring of Revenue compliance across multi-disciplinary teams. 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities: 

• Operational/Procedural Responsibilities
  • Serves as an internal resource to clinical departments around professional charge capture and professional charge master updates
  • Works with the revenue producing departments to ensure the ongoing coordinated consistency of the Chargemaster, including accurate descriptions, coding, additions, deletions, pricing and any other changes
  • Monitors revenue compliance with clinical departments, evaluating professional charge capture processes for new and existing services, implementing best practices
  • Participates in ongoing coordination and resolution of revenue issues as they arise ensuring the overall integrity of the charge capture process
  • Monitors professional charging mechanisms and systems with in-depth knowledge of how orders and charges are entered and of the various system workflows to ensure proper generation of charges for billing 
  • Analyzes reports to determine areas of improvement and determine appropriate plan of action by reviewing data and systems to target areas of improvement
  • Maintain a timely turnaround of all requests.
  • Maintain high productivity and quality with minimal supervision
  • Yearly continuing education is required
  • Ability to multi-task and work under aggressive deadlines
  • Possess effective time management skills to permit handling of a large workload
• Financial Responsibilities           
  • Performs analysis 
  • Ability to understand and analyze payer regulations and impact to the Professional Chargemaster on reimbursement and coding guidelines
  • Disseminates CMS updates to health care providers and clinical departments as they relate to billing, ensuring the necessary changes are implemented.
  • conducts internal reviews to improve revenue cycle, claims production and coding integrity
  • Monitors compliance with corporate, federal, and state guidelines bringing forward changes, as applicable, while focusing on accuracy and revenue cycle integrity
  • Maintains a solid working knowledge of the revenue cycle process to aid in the implementation of regulatory standards assuring appropriate and timely cash collection
  • Troubleshoot and resolve issues related to the revenue cycle by developing, presenting and implementing recommendations
• Responsibilities for Relationships           
  • Develop and maintain solid working relationships with internal and external customers
  • Collaborate with managerial and supervisory staff to ensure compliant regulatory billing with correct coding on accounts
• Performs similar or related duties as requested or directed
  • Performs other duties as requested and observed by supervisor or manager

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 5+ years of relevant experience e.g. patient billing and revenue cycle experience, experience in finance within a healthcare organization
• 5+ years of experience CPT/HCPCS, UB-04 Revenue Coding, modifiers, billing regulations APC’s, APG’s and DRG’s
• 3+ years of experience with Epic
• Proficient in the use of Microsoft Office Programs, including but not limited to Excel, Word, and Access
   

Preferred Qualifications:

• 5+ years of revenue cycle processes within a healthcare organization
• 5+ years of financial related work experience
• 5+ years of experience with CMS coding and compliance rules
• 5+ clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology
• Solid professional billing knowledge
• Demonstrated familiarity with Epic – resolute and clinical apps
• Demonstrated ability to organize and assess various statistical and financial data and put forth conclusions based on data collected.
• Demonstrated ability to accomplish a defined scope of job performance through independent investigation, self-motivation, analytical and problem- solving techniques

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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 salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.