Senior Business Analyst Revenue Integrity - Remote

$70,200 - $137,800/Yr

UnitedHealth Group - Hartford, CT

Full-time - Mid Level

Remote - Hartford, CT

Insurance Carriers and Related Activities

About the position

The Senior Business Analyst for Revenue Integrity at UnitedHealth Group is responsible for overseeing compliant Charge Description Master (CDM) functions, including reimbursement analysis and monitoring revenue compliance across various clinical departments. This role involves ensuring the accuracy of charge capture processes, implementing negotiated payer rates, and maintaining the corporate charge master to support healthcare affiliates. The position requires collaboration with clinical departments to resolve revenue issues and improve health outcomes through effective charge management.

Responsibilities

• Serve as an internal resource to clinical departments regarding charge capture and charge master updates.
• Ensure ongoing consistency of the Chargemaster, including accurate descriptions, coding, and pricing changes.
• Monitor revenue compliance and evaluate charge capture processes for new and existing services.
• Participate in the resolution of revenue issues to maintain the integrity of the charge capture process.
• Maintain the corporate charge master and provide education to affiliates for consistency and standardization.
• Analyze reports to identify areas for improvement and develop action plans based on data.
• Ensure timely turnaround of Chargemaster requests, including new codes and price changes.
• Supervise Chargemaster management functions and coordinate research on coding and billing guidelines.
• Perform analyses to understand the net revenue effect of proposed Chargemaster changes.
• Disseminate CMS updates to healthcare providers and ensure timely changes to Chargemaster files for compliant billing.
• Conduct internal reviews to enhance revenue cycle and coding integrity.
• Develop and maintain relationships with internal and external customers to ensure compliant regulatory billing.

Requirements

• High School diploma
• 10+ years of relevant experience in patient billing and revenue cycle
• 5+ years of experience with CPT/HCPCS, UB-04 Revenue Coding, and billing regulations
• 5+ years of experience with the CDM and its relationship to finance and clinical operations
• 3+ years of knowledge with Epic
• Proficient in Microsoft Office Programs, including Excel, Word, and Access

Nice-to-haves

• 10+ years of revenue cycle processes within a healthcare organization
• 5+ years of experience with financial-related work
• 5+ years of CMS coding and compliance rules
• Experience in clinical settings such as Laboratory, Radiology, or Cardiology
• Familiarity with Epic - Resolute and clinical apps

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution