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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Position in this function is responsible for the oversight of charge description master, billing, and reimbursement analysis within Revenue Integrity. Carries out aggressive program of assessing and improving charging practices across the organization.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary 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
Organizational Responsibility
- 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
Additional Job Information
- This job description describes the general nature and level of work required by the position. It is not intended to be an all-inclusive list of qualifications, skills, duties, responsibilities or working conditions of the job. Specific duties and responsibilities consistent with the general nature and level of work described may vary by department and additional related duties may be assigned as needed. Some duties listed may not apply to all employees with this job description. The job description is subject to change with or without notice, and Management reserves the right to add, modify or remove any qualification or duty
- Nothing in this job description changes the existing at-will employment relationship between the Organization and the employee occupying the position
- Training is provided relevant to the population served, based on scope of care of the service assignment
- Owensboro Health is committed to providing a safe working environment including training and access to person protective equipment necessary to this position. While performing duties of this position, occupational exposure to bloodborne pathogens is present for all employees
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.
Years of post-high school education can be substituted/is equivalent to years of experience
Required Qualifications:
- 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
Preferred Qualifications:
- Proven critical thinking skills and decisive judgment
- Proven works under minimal supervision
- Demonstrated ability to work in a stressful environment and take appropriate action
California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $67,800 to $133,100 per year. 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. APPLY HERE