Senior Business Analyst Revenue Integrity - Remote

$70,200 - $137,800/Yr

UnitedHealth Group - Saint Louis, MO

Full-time - Mid Level

Remote - Saint Louis, MO

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 overall revenue cycle integrity, all while working remotely within the U.S.

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 ensure consistency across affiliates.
• Analyze reports to identify areas for improvement and develop action plans.
• Maintain 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 ensure compliance with billing for drugs and other items.
• Conduct internal reviews to improve revenue cycle and coding integrity.
• Develop and maintain relationships with internal and external customers to ensure compliant 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 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