Note: The job is a remote job and is open to candidates in USA. Optum is hiring a Revenue Integrity & Chargemaster Analyst to oversee chargemaster, billing, and reimbursement analysis within Revenue Integrity. The role assesses and improves charging practices, supports compliant charge capture and billing, and analyzes financial impacts of chargemaster changes.

Responsibilities

• Supervision and coordination of chargemaster and charge capture processes in researching coding and billing guidelines, researching insurance contracts, and updating hospital and professional chargemaster and charge capture processes
• Represents Owensboro Health with external vendors (e.g. EPIC)
• Works diligently with department heads, supervisors, staff, coders, and patient accounting personnel to continuously improve the goals of enhancing reimbursement, speeding up cash flow, and maximizing fiscal compliance
• Works with the revenue producing departments to ensure ongoing coordinated and consistency with the chargemaster and charge capture processes, including accurate descriptions, coding, additions, deletions, pricing, revenue code, and any other changes
• Maintains a working knowledge of revenue cycle processes to aid in the implementation of regulatory standards that assists the health system in cash collection while accurately complying with billing guidelines
• Works with Finance, Revenue Integrity and Decision Support to perform applicable analyses to understand budget, net revenue change, and labor impact of proposed chargemaster changes
• Performs analysis, identifies trends, validates compliance as related to fiscal activities generating additional revenue, reducing bad debt expense and charity write-offs, and overall expense reductions
• Distributes Centers for Medicare and Medicaid Services (CMS) updates to health care providers as they relate to billing for drugs and implantable and/or other pass-through eligible items and ensuring the necessary changes are made to the entity specific chargemaster and charge capture updates within the time frame for accurate and compliant billing
• Advises and collaborates with the Compliance Officer, Internal Audit, Regulatory Review and Analysis, legal counsel, and outside consultants to analyze, review, and assess identified billing, coding, charging and compliance issues
• Revenue codes and coding assignments for all new items or services throughout Owensboro Health
• Oversees the overall maintenance and use of the chargemaster tool utilized by Revenue Integrity
• Recommends policies and procedures which impacts charge capture and pricing practices
• Adheres to all organizational policies and procedures. Executes all tasks and behaves in a manner consistent with a culture of compliance, safety and a high reliability organization; behavior supports the organization's core commitments of Integrity, Service, Respect, Teamwork, Excellence, and Innovation

Skills

• 2+ years of relevant experience required in any of the following: billing, charging, Charge Master, coding or health care revenue cycle
• 2+ years of experience working with CPT/HCPCS, UB-92 Revenue Coding, modifiers, billing regulations, and APCs
• 2+ years of experience working with Epic Software
• Proven critical thinking skills and decisive judgment
• Proven works under minimal supervision
• Demonstrated ability to work in a stressful environment and take appropriate action

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
• Flexibility to work remotely from anywhere within the U.S.; for hires in the Minneapolis or Washington, D.C. area, work in the office a minimum of four days per week
• Training provided relevant to the population served, based on scope of care of the service assignment
• Career development opportunities
• Development for other roles you may be interested in

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