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Enterprise Revenue Integrity Audit Analyst

Employer
UnitedHealth Group
Location
Westchester, Florida, United States
Closing date
Jun 19, 2023

View more

Job Role
Auditor
Sector
Finance
Contract Type
Permanent
Hours
Full Time
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.SM

Under the direction of the Enterprise Manager of Revenue Integrity Charge Audit and Optimization, the Revenue Integrity Audit Analyst I analyzes key metrics, performs charge audits, and compiles audit findings to develop and implement action plans to preserve and enhance revenue.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
  • Works collaboratively with managers and peers to preserve and enhance the integrity of revenue
  • Develops and maintains relationships with key stakeholders within the member organization including but not limited to coding, PFS, charge services, and department leaders
  • Contributes to process improvement initiatives within the enterprise revenue cycle by recognizing process improvement opportunities, anticipating and proposing opportunities, engaging stakeholders, conducting root cause analyses, and developing and executing plans to achieve best practice
  • Works collaboratively with peers and managers to review audit results and assist in developing plans of action or education as needed
  • Works collaboratively with Decision Support, RI Chargemaster Analysts, Charge Services, Compliance, Contracting and other departments to vet new service line requests prior to implementation
  • Runs established reports and export data from the EMR and billing software systems
  • Analyzes key performance metrics, reports audit findings clearly and concisely in a format appropriate for remediation
  • Works collaboratively with the Revenue Integrity EHR Liaison, Charge Master Analysts and IS to optimize the use of charge capture methodologies for clinically driven charge capture
  • Works collaboratively with peers and managers to provide feedback and education to the member organization to preserve and enhance the integrity of revenue
  • Maintains a working knowledge of industry best practices, guiding principles, regulatory mandates, and payer requirements and applies understanding in the dissemination of education
  • Continually works to preserve and enhance the integrity of revenue
  • Provides support for new charges implementation which may include testing, auditing, reporting and follow-up with department leaders
  • Keeps abreast of current regulatory guidance which may include attending local, regional, or national conferences/seminars to remain current

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:
  • Bachelor's Degree (or higher) OR 2+ years of experience in revenue cycle operations
  • 2+ years of experience in hospital billing practices and reimbursement methodologies including DRG, APC, Cost Based and other payment methodologies
  • Intermediate level of proficiency with Microsoft Excel, using Pivot Tables, V Lookups, etc.
  • Ability to work 8:00 AM - 4:30 PM EST

Preferred Qualifications:
  • Experience reading EMR Notes and Orders
  • Basic understanding of Charge Master elements (CPT, HCPCS, Revenue Code, etc.)

Soft Skills:
  • Strong analytical and data interpretation skills
  • Excellent written, data reporting, and verbal communication skills
  • Ability to manage multiple projects and effectively prioritize projects to meet established deadlines working both independently and collaboratively
  • Ability to handle difficult and stressful situations with professional composure

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

California, Colorado, Connecticut, Nevada, New York, Washington or Rhode Island Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, Washington or New York City residents is $22.45 to $43.89. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO, #GREEN

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