Senior Business Analyst Revenue Integrity - Remote

$70,200 - $137,800/Yr

UnitedHealth Group - Eden Prairie, MN

Full-time - Mid Level

Remote - Eden Prairie, MN

Insurance Carriers and Related Activities

About the position

The Senior Business Analyst for Revenue Integrity at UnitedHealth Group is responsible for overseeing Charge Description Master (CDM) functions, ensuring compliance and accuracy in charge capture processes across various clinical departments. This role involves reimbursement analysis, monitoring revenue compliance, and implementing payer rates within the Hospital Billing software. The position requires collaboration with multiple teams to enhance revenue cycle integrity 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 consistency of the Chargemaster across revenue-producing departments, including accurate descriptions, coding, and pricing changes.
• Monitor revenue compliance and evaluate charge capture processes for new and existing services.
• Coordinate and resolve revenue issues to maintain the integrity of the charge capture process.
• Maintain the corporate charge master and provide education to support consistency across the Bassett Healthcare Network.
• Analyze reports to identify areas for improvement and develop action plans based on data review.
• Ensure timely turnaround of Chargemaster requests, including new codes and price changes.
• Supervise Chargemaster management functions, researching coding and billing guidelines, and updating system Charge masters.
• Analyze the net revenue effect of proposed Chargemaster changes in collaboration with finance and clinical operations.
• Disseminate CMS updates to ensure compliance with billing for drugs and other items, making necessary changes to Chargemaster files.
• 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 experience within a healthcare organization
• 5+ years of financial-related work experience
• 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