Revenue Assurance Audit Analyst

UnitedHealth Group•Bangor, ME

2d•$29 - $52•Remote

About The Position

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.

Requirements

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.)
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
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Candidates are required to pass a drug test before beginning employment.

Nice To Haves

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

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