Senior Business Analyst - Hospital charges - Sacramento - Full-time / Part-time

You believe data can help reshape the future, and you find yourself loving the thrill of diving into challenging analysis. At UnitedHealth Group, you'll find an organization that will recognize those talents and have lots of growth potential. Here, you will be empowered, supported and encouraged to use your analysis expertise to help change the future of health care. Does the challenge intrigue you?

As a key member of the Analyst team, you will be part of UnitedHealth Group's mission of helping people live healthier lives. As a Senior Business Analyst, you will grow and develop as you maintain and audit functions of multiple, system focused Charge Description Masters (CDM).  In this role, you will deliver, monitor, and maintain a consistent accurate CDM that is compliant with regulatory agencies. The position provides advice, and support to region/facility staff.  You will work in a cooperative team environment to provide value to customers both internal and external to Optum 360.

Primary Responsibilities:

• Maintain the Charge Description Master (CDM) in compliance with regulatory agencies and Hospital policy (i.e., updates E/M protocol annually; maintain current CODI documents).


• Responsible for making CDM related decisions that require significant analysis and investigation with solutions requiring significant original thinking.


• Maintain current knowledge in applicable rules and regulations governing CDM, disseminates relevant information to the Corp CDM team and to facility CDM analysts.


• Responsible for CMS Transmittal and Medi-Cal Bulletin distribution to CDM analysts within established timeframe and for maintaining Transmittal Log.


• Responsible for CDM Team SAC Inbox. Responds to Inbox questions within 24 hours. Proactively ensures coverage of Team Inbox when out of office. Interact with leadership, department managers and regional facility staff members regarding alignment and adherence to corporate standard, regulatory compliance and reimbursement issues.


• Work closely with assigned hospitals post-standardization to ensure ongoing compliance with the Corporate Standard. Communicate alignment audit findings with the necessary parties and follow up to ensure identified issues are corrected.


• Take initiative to identify system and/or operational problems and participate in the development of solution for improvement to billing functions for facilities.


• Keep Supervisor informed when assigned responsibilities may not be completed within established timeframe.


• Demonstrate flexibility and willingness to support the changing needs and priorities of the department and organization.

Required Qualifications:

• Bachelors degree in Business, Finance, Health Administration,related field or equivalent work experience.


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  3 years experience with hospital charge description master maintenance, charge audit, or billing, and knowledge of hospital inpatient and outpatient coding/ billing codes required.



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  Microsoft Excel experience (intermediate)



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  Experience with medical records coding and/or patient accounting.  Experience with coding/charging in a clinical setting preferred.



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  Ability to work independently.



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  Ability to access various websites for research of CDM issues. Knowledge of billing and collections processes in a hospital setting most desirable.



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  Working knowledge of current Medicare and other regulatory billing guidelines required.



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  Access Database Experience desired.



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  Comprehensive experience with inpatient and outpatient billing requirements of billing forms (UB-04, HCFA 1500) preferred.



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  Medi-Cal Coding experience preferred.



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  Patient Accounting/PFS experience preferred.



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  Analytical/Critical Thinking /Problem Solving.



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  Strong communications skills



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  Attention to Detail, Accuracy



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  Organizational skills



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  Knowledge and application of OPPS CPT/HCPCS, revenue codes, modifiers and Medicare regulations



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  Managed Care Contract knowledge

  
  
  Health care isn't just changing. It's growing more complex every day. ICD10 replaces ICD9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. And that's what fueled these exciting new opportunities.
  
  Optum360 is a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage all our resources to bring financial clarity and a full suite of revenue management services to health care providers nationwide.
  
  If you're looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.SM