Job details
Job type full-time
Full job description
If you`re the kind of thinker and leader who wants to bring your contribution to a new level every day, bring yourself over to optumYou`ll discover an opportunity to do your life`s best work.(sm)
The senior compliance analyst gathers, formats and analyzes large data sets to identify various compliance concerns related to end-to-end revenue cycle, including patient access, coding and billing/collections, and clearly communicates resultsData analysis supports one-time projects or ongoing compliance monitoringThe senior compliance analyst will also review specific accounts to identify if appropriate actions were takenThis position will assist compliance department team members by tracking corrective action plan due dates, validating completion of action plans and verifying ongoing compliance.
You’ll enjoy the flexibility to telecommute* from anywhere within the u.sAs you take on some tough challenges.
Primary responsibilities
Analyzes large data sets for patterns and trends to verify compliance
Reviews patient access, billing and claims information to identify root cause of potential concernsSummarizes findings for review by compliance and operational managers
Validates audit corrective action plans have been properly implemented through process and document review
Validates accuracy of rebilled claims and tracks timeliness
Validates accuracy of claims relating to, one-day stay self-denials, three-day payment window, medical device credits, etc.
Supports annual compliance risk assessment process through tracking of identified risk areas, ranking and analysis
Interacts with multiple functions within optum360 and the client organization including compliance, legal, reimbursement, finance, operations, human resources and internal audit as necessary to assist in investigating various revenue cycle related compliance concerns
Performs internal monitoring and reviews to ensure compliance with laws, rules, and policies governing optum360`s operations
Researches and maintains awareness of new laws, rules and regulations applicable to and impacting optum360`s operations
Anticipates and identifies areas of improvement for the compliance program and participates in developing compliance performance improvement projects and activities
Support privacy incident management, investigation and reporting process
Researches and maintains awareness of new laws, rules and regulations applicable to and impacting optum360`s operations
Completes work independently; ability to understand and implement action plans based on general guidance
Performs other duties as assigned
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
Bachelor’s degree or relevant work experience
2+ years of data analysis experience
2+ years of hospital revenue cycle/hospital billing experience
Knowledge and understanding of healthcare industry regulations and guidelines, specifically medicare
Preferred qualifications
Experience working in healthcare billing and medical record systems
Knowledge of hipaa privacy regulatory requirements
Audit experience
Unitedhealth group requires all new hires and employees to report their covid-19 vaccination status.
Careers at optumcareWe`re on a mission to change the face of health careAs the largest health and wellness business in the us, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goalsFortunately, we have a team of the best and brightest minds on the planet to make it happenTogether we`re creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us allJoin us and learn why there is no better place to do your life`s best work.(sm)
Optumcare is committed to creating an environment where physicians focus on what they do best: care for their patientsTo do so, optumcare provides administrative and business support services to both owned and affiliated medical practices which are part of optumcareEach medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient careOptumcare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
*all telecommuters will be required to adhere to unitedhealth group’s telecommuter policy.
Colorado residents only: the salary range for colorado residents is $64,800 to $116,000Pay is based on several factors including but not limited to education, work experience, certifications, etcIn 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
Diversity creates a healthier atmosphere: optumcare is an equal employment opportunity/affirmative action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Optumcare is a drug-free workplaceCandidates are required to pass a drug test before beginning employment
Job keywords: data analysis, revenue cycle, hospital revenue cycle, hospital billing, healthcare, medicare, hipaa, audit, telecommute, telecommuter, remote , work from home
