Senior Business Analyst Revenue Integrity - Remote

$70,200 - $137,800/Yr

UnitedHealth Group - Nashville, TN

Full-time - Senior

Remote - Nashville, TN

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.
• 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 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 accordingly.
• Perform analyses to understand the net revenue effect of proposed Chargemaster changes in collaboration with finance and clinical operations.
• Disseminate CMS updates to healthcare providers and ensure timely changes to Chargemaster files for accurate billing.

Requirements

• High School diploma
• 10+ years of relevant experience in patient billing and revenue cycle management within a healthcare organization
• 5+ years of experience with CPT/HCPCS, UB-04 Revenue Coding, and billing regulations
• 5+ years of experience with the Charge Description Master (CDM) and its relationship to financial areas
• 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 experience with CMS coding and compliance rules
• Experience in clinical settings such as Laboratory, Radiology, or Cardiology
• Familiarity with Epic - Resolute and clinical applications.

Benefits

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