Charge Master Analyst

About the Role

Optum is a global organization dedicated to improving health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need. This remote position is responsible for the oversight of the charge description master, billing, and reimbursement analysis within Revenue Integrity. The role involves assessing and improving charging practices across the organization.

Key Responsibilities

• Supervision and coordination of chargemaster and charge capture processes through research of coding and billing guidelines, insurance contracts, and updates to hospital and professional chargemasters.
• Representing Owensboro Health with external vendors such as EPIC.
• Collaborating with department heads, supervisors, staff, coders, and patient accounting personnel to improve reimbursement, accelerate cash flow, and maximize fiscal compliance.
• Working with revenue-producing departments to ensure consistency with the chargemaster and charge capture processes, including accurate descriptions, coding, additions, deletions, pricing, revenue codes, and other changes.
• Maintaining a working knowledge of revenue cycle processes to implement regulatory standards that assist the health system in cash collection while complying with billing guidelines.
• Collaborating with Finance, Revenue Integrity, and Decision Support to analyze budget, net revenue change, and labor impact of proposed chargemaster changes.
• Performing analyses to identify trends, validate compliance related to fiscal activities, generate additional revenue, reduce bad debt expense and charity write-offs, and achieve overall expense reductions.
• Distributing Centers for Medicare and Medicaid Services (CMS) updates to healthcare providers concerning billing for drugs and implantable/pass-through eligible items, ensuring necessary changes are made to the entity-specific chargemaster and charge capture updates within required timeframes.
• Advising and collaborating with the Compliance Officer, Internal Audit, Regulatory Review and Analysis, legal counsel, and outside consultants on identified billing, coding, charging, and compliance issues.
• Assigning revenue codes and coding for all new items or services.
• Overseeing the maintenance and use of the chargemaster tool utilized by Revenue Integrity.
• Recommending policies and procedures impacting charge capture and pricing practices.

Requirements & Tech Stack

• 2+ years of experience in billing, charging, Charge Master, coding, or healthcare revenue cycle.
• 2+ years of experience working with CPT/HCPCS, UB-92 Revenue Coding, modifiers, billing regulations, and APCs.
• 2+ years of experience working with Epic Software.

Qualifications

• Proven critical thinking skills and decisive judgment.
• Proven ability to work under minimal supervision.
• Demonstrated ability to work in a stressful environment and take appropriate action.
• Remote employees must adhere to UnitedHealth Group's Telecommuter Policy.

The specific duties and responsibilities may vary by department.

Training is provided relevant to the population served.