Senior Business Analyst Revenue Integrity Specialist

2 days ago

Hartford, Connecticut, United States UnitedHealth Group Full time
Job Summary

UnitedHealth Group is seeking a Senior Business Analyst Revenue Integrity to join our team. As a key member of our Revenue Integrity team, you will be responsible for ensuring the accuracy and integrity of our revenue cycle processes.

This role will involve working closely with clinical departments, revenue producing departments, and other stakeholders to ensure the ongoing coordinated consistency of the Chargemaster, including accurate descriptions, coding, additions, deletions, pricing, and any other changes.

You will also be responsible for monitoring revenue compliance with clinical departments, evaluating charge capture processes for new and existing services, implementing best practices, and participating in ongoing coordination and resolution of revenue issues as they arise.

In addition, you will maintain corporate charge master to support Affiliates in the Bassett Healthcare Network by providing education and planning activities to ensure consistency and standardization of the charge masters.

Key Responsibilities:

  • Operational/Procedural Responsibilities
  • Serves as an internal resource to clinical departments around charge capture and charge master updates
  • Works with the revenue producing departments to ensure the ongoing coordinated consistency of the Chargemaster
  • Monitors revenue compliance with clinical departments, evaluating charge capture processes for new and existing services
  • Participates in ongoing coordination and resolution of revenue issues as they arise
  • Maintains corporate charge master to support Affiliates in the Bassett Healthcare Network
  • Monitors facility charging mechanisms and systems with in-depth knowledge of how orders and charges are entered and of the various system workflows
  • Analyzes reports to determine areas of improvement and determine appropriate plan of action
  • Maintains timely turnaround of all Chargemaster requests
  • Maintains 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

Requirements:

  • High School diploma
  • 10 years 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
  • 5 years of experience with the CDM and its relationship to related areas such as the General Ledger, cost Accounting, Productivity, Cost Reporting and Budget
  • 3 years of knowledge with Epic
  • Proficient in the use of Microsoft Office Programs, including but not limited to Excel, Word, and Access

Preferred Qualifications:

  • 10 years of revenue cycle processes within a healthcare organization
  • 5 years of experience with Financial related work experience
  • 5 years of CMS coding and compliance rules
  • 5 clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology
  • Familiarity with Epic - Resolute and clinical apps

UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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