Bring us your experience, your head for strategy, your strength with relationships and your eye for opportunity. In return we offer an unmatched place to grow and develop your career among a richly diverse group of businesses driven by the power and stability of a leading health care organization. Come help us heal and strengthen the health care system as you do your life's best work.(sm) Senior Compliance Analyst will review and audit revenue cycle related billing compliance concerns, as well as support the Corporate Integrity Agreement Program Manager, Compliance Sr. Directors and the Vice President, Revenue Cycle Compliance and Quality and other Compliance team members with data analysis and other reporting. If you are located in the Southwest US, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Conduct detailed audit and analysis of billing and claims information to identify root cause of potential concerns. Summarize findings for review by Compliance and operational managers Validate audit corrective action plans have been properly implemented through detailed process and document review Analyze and validate large, complex data files prior to submission to internal or external reviewers Validate accuracy of rebilled claims and track timeliness Validate accuracy of claims relating to 340B drugs, one - day stay self - denials, three - day payment window, medical device credits, etc. Compile and organize supporting documentation / evidence for audits and / or to support rebilling activities Maintain detailed tracking and reporting of compliance concerns, initiatives and activities Works effectively and collaboratively with colleagues, employees, internal clients, business partners and key customers, vendors, and management within Optum360, responding promptly and efficiently to emails, telephone calls, and complaints that come through the hotline Researches and maintains awareness of new laws, rules and regulations applicable to and impacting Optum360's operations Performs other duties as assigned
Required Qualifications: Bachelor's Degree and experience in provider revenue cycle with a combination of professional training and / or work experience which demonstrates the ability to perform the duties of the position 4+ years of experience working in a government or healthcare environment Knowledge and understanding of healthcare industry regulations and guidelines, specifically Medicare Knowledge of HIPAA related release of information requirements Preferred Qualifications: Professional certification in one or more of the following areas: Certified Internal Auditor (CIA), Healthcare Compliance Professional (HCP), Project Management Professional (PMP), Certified Healthcare Financial Professional (CHFP), or similar Experience in revenue cycle or billing operations desired with experience in auditing Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Compliance Analyst, Compliance, Analyst, CIA, HCP, PMP, CHFP, Phoenix, AZ, Arizona, Sacramento, CA, California, Telecommute
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.