Revenue Assurance Audit Analyst

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. 

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

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

Primary Responsibilities:  

• Works collaboratively 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
• Contributes to the development and maintenance of policies and education  
• Proven ability to create ad hoc reports from the EMR and billing software systems
• Works collaboratively with peers and managers to review audit results and takes the lead in developing plans of action or education as needed/directed by the Manager
• Ability to be the representative for the RI Audit Team with Decision Support, RI Chargemaster Analysts, Charge Services, Compliance, Contracting and other departments to vet new service line requests prior to implementation  
• Independently analyzes key performance metrics, reports, and audit findings to develop and implement strategic plans to preserve and enhance revenue 
• Maintains a working knowledge of industry best practices, guiding principles, regulatory mandates, and payer requirements and applies understanding in the dissemination of education  
• Completes all annual educational as required by NLH HR and Revenue Integrity leadership
• Continually works to preserve and enhance the integrity of revenue  
• Excellent written and verbal communication skills; able to compile data in an easy-to-read format
• Provides exceptional customer service
• Provides back-up support and assist within the department as needed  
• All other Duties as assigned

Qualified candidates will be expected to effectively demonstrate:

• Ability to manage multiple projects and affective prioritization 
• Ability to complete time sensitive projects and work both independently and collaboratively  
• Ability to handle difficult and stressful situations with professional composure
• Keeps abreast of current regulatory guidance and attends 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:

• 4+ years of progressive, relevant knowledge in revenue cycle operations with focus toward mastery in the field accepted in lieu of bachelor's degree.
• In depth understanding of regulatory guidance, governments and commercial payer regulations related to hospital revenue cycle and the ability to interpret them and apply toward best practices within the enterprise revenue cycle
• In depth understanding of hospital billing practices and reimbursement methodologies including DRG, APC, cost-based and other payment methodologies
• Proven history of analytical and data interpretation skills 
• Demonstrated ability to research, define, effectively communicate, analyze and problem solve trends within the Revenue Cycle for resolution 
• Demonstrated ability to direct Revenue Integrity Analysts in projects for successful outcome
• Demonstrated Intermediate level Microsoft Excel skills (specifically Pivot Tables, CONCATENATE, VLOOKUP, etc.)

Preferred Qualifications:

• Familiarity with NorthernLight Health systems 
• Demonstrated understanding of charge methodologies and revenue cycle best practices 
• Demonstrated understanding of the Charge Master elements
• Experience with researching, defining, effectively communicating, analyzing and problem-solving trends within the Revenue Cycle for resolution
• Experience reading and interpreting EMR Notes and Orders

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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