Epic Business Process Analyst - Remote

UnitedHealth Group Inc.•San Francisco, CA

73d•Remote

About The Position

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Revenue Integrity program is a core function of the revenue cycle. This involves monitoring and analyzing key performance metrics to identify areas of opportunity. Developing and implementing efficient, effective processes to eliminate revenue leakage and ensure timely compliant billing and reimbursement. Revenue Integrity is a critical role of revenue cycle management to ensure financial success and mitigate risk. This team operates within the MPP pillar, focusing on revenue integrity, charge description master management, and ensuring accurate billing and payment processes for hospital and medical groups, with oversight of regulatory compliance and claim processing. As a Business Process Analyst Reviewing and identifying revenue cycle system failure points, this includes reviewing clinical and financial systems and processes. Working collaboratively and establishing relationships across the revenue cycle continuum. Performing root cause analysis, Engaging and enabling all key stakeholders in areas of focus, responsibility, and accountability This position will support a customer using Epic for billing and electronic health records, requiring the Business Process Analyst to work with Epic work queues, analyze data from Epic reports and modules, and identify process or system improvements to reduce claim denials. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. 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.

Requirements

3+ years of work experience in a health care environment dealing with billing, coding, revenue cycles, compliance, or CDM type work
Experience with Epic and hospital billing processes including claim creation, submission to insurance companies, and payment reconciliation
A basic understanding of coding and how it integrates with billing
Intermediate or better level of proficiency with Excel
Proven ability to communicate analysis including trends and opportunities to clients and the business both verbally and through writing

Nice To Haves

AHIMA or AAPC Certified medical coder
Knowledge of revenue cycle processes within a healthcare organization
Knowledge of CMS coding and compliance rules
Proven ability to solve problems including multiple priorities and research conflicting and / or inaccurate data

Responsibilities

Interact with leadership, department managers and regional facility staff members regarding alignment and adherence to corporate standards, regulatory compliance and reimbursement issues
Maintain current knowledge in applicable rules and regulations governing CDM and disseminates relevant information to the CDM team and other areas of the Revenue Cycle
Responds to customer inquiries and requests professionally and can analyze revenue cycle questions and issues to resolution
Demonstrate flexibility and willingness to support the changing needs and priorities of the department and organization- Uses pertinent data and facts to identify and solve a range of problems within area of expertise