Remote Revenue Integrity & Analytics Lead

Optum; Las Vegas (NV); Remote; USD 40,000 - 72,000; Full time

Benefits offered by this job

Remote work within the US

In-office 2x/month in Las Vegas

Job summary

Optum is a global organization delivering care aided by technology to help millions live healthier lives. The Revenue Integrity Supervisor oversees West revenue integrity processes to drive reimbursement, pricing accuracy and charge capture expertise.

You’ll enjoy the flexibility to work remotely from anywhere in the U.S.; Las Vegas hires must come to the office at least 2 times per month during PST hours (8 am–5 pm, Mon–Fri).

Qualifications

• Experience in Healthcare Revenue Cycle Operations and revenue integrity.
• Experience delivering actionable insights from data and big data analytics environments.
• Working knowledge of ICD, CPT, HCPCS coding.
• Exposure to healthcare data from multiple sources (payor claims, EDI, EHR).
• Ability to work with multi-disciplinary teams and leadership levels.
• Knowledge of federal/state/private payer requirements and authorizations.

Responsibilities

• Oversee daily revenue integrity operations including payer payments and pricing applications.
• Maintain chargemaster and fee schedules; update annually and quarterly.
• Monitor charge-capture controls and revenue reconciliation.
• Review and resolve Epic charge-related work queues and edits.
• Identify and correct charge, billing, documentation, and coding errors per ICD/CPT/HCPCS and payer rules.
• Serve as primary resource for charge-related questions and payer requirements.
• Identify opportunities to optimize practice management and revenue cycle tech; standardize reporting.
• Analyze KPI dashboards and monthly operational reports for stakeholders.
• Identify revenue gaps and opportunities to accelerate collections and prevent losses.
• Coordinate denials and payer audits; escalate reimbursement issues as needed.
• Monitor payer guidance and policies; implement compliant changes.
• Review revenue cycle metrics with leaders and develop improvement plans.
• Support payer contract configuration and monitor payments vs contractual terms.
• Participate in revenue cycle improvement initiatives.

Skills

Revenue cycle operations

Advanced analytics

Medical coding

Data integration

Leadership experience

Payer requirements

Excel

Problem solving

Communication

Tools

Microsoft Project

Microsoft PowerPoint

Microsoft Word

Job description

Optum is a global organization delivering care aided by technology to help millions live healthier lives. The Revenue Integrity Supervisor oversees West revenue integrity processes to drive reimbursement, pricing accuracy and charge capture expertise.

You’ll enjoy the flexibility to work remotely from anywhere in the U.S.; Las Vegas hires must come to the office at least 2 times per month during PST hours (8 am–5 pm, Mon–Fri).