Healthcare Systems Revenue Cycle Compliance Auditor

Posted 6 Days Ago
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Eden Prairie, MN, USA
In-Office
92K-164K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Plan and execute financial, operational, and compliance audits across the healthcare revenue cycle. Perform risk assessments, analyze data, prepare audit reports, monitor corrective actions, and advise stakeholders on regulatory adherence and process improvements. Collaborate with compliance, legal, and business leaders to strengthen controls and ensure implementation of recommendations.
Summary Generated by Built In
Requisition Number: 2369955
UnitedHealth Group is a health care and well-being company that's dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others. Join us to start Caring. Connecting. Growing together.
Quality at UnitedHealth Group means striving for excellence in everything we do in order to help us achieve our Mission. Simply put, it's in our DNA and why we're in business - to help people. Our Mission serves as our why; our Values unite us around how we will achieve it. Because when we follow our Mission and live our Values, we deliver Quality.
We are seeking a detail-oriented and analytical professional to join our team as a Healthcare System Revenue Cycle Compliance Auditor. This role is responsible for planning and conducting audits of financial, operational, and compliance processes across the revenue cycle. The ideal candidate will have a strong understanding of healthcare regulations, exceptional data analysis skills, and the ability to identify and mitigate compliance risks. They will collaborate closely with business leaders and compliance teams to ensure operational integrity, regulatory adherence, and continuous process improvement. A successful candidate will be proactive, highly organized, and committed to delivering high-quality, value-added audit services.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Audit Planning & Execution
  • Plan, organize, and conduct financial, operational, and compliance audits of the revenue cycle
  • Evaluate front-end and back-end revenue cycle processes to identify compliance risks and strengthen controls
  • Perform risk assessments to identify and prioritize audit focus areas

Reporting & Follow-Up
  • Prepare clear, concise, and objective audit reports with findings, observations, and recommended corrective actions
  • Ensure adequacy and timely completion of corrective action plans
  • Monitor implementation of corrective actions and provide consultation as needed

Risk & Compliance Monitoring
  • Identify business risks and recommend efficiency improvements
  • Stay current on healthcare regulations and compliance trends
  • Research and synthesize regulatory information for stakeholders in an understandable format

Collaboration & Relationship Management
  • Develop and maintain strong working relationships with compliance leadership, legal teams, and subject matter experts
  • Partner with business leaders and functional owners to support compliance initiatives

Quality & Process Improvement
  • Deliver high-quality work products consistently
  • Contribute to team goals and suggest improvements to compliance processes

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:
Before applying, please ensure each of these experiences are stated clearly on your resume under each applicable employer entry.
  • 5+ experience with hospital Revenue Cycle process knowledge gained through management or audit experience
  • 5+ experience in process auditing, including data acquisition and analytics, workpaper preparation, professional report writing and process visualizations, including:
    • Exceptional data analysis capabilities to interpret complex information and identify trends or risks
    • Expertise in researching and auditing to Federal and State regulations, payer guidelines, regulatory agency publications and industry standards for hospitals and physician practices
  • Professional designation in one or more of the following areas or similar:
    • Certified Healthcare Internal Auditor Professional (CHIAP)
    • Certified Internal Auditor (CIA)
    • Certified Public Accountant (CPA)

PREFERRED SKILLS/ QUALIFICATIONS
  • Experience with EPIC, MS4, Meditech, SMS Invision, Cerner, Star and other Healthcare platforms or technologies
  • Advanced level of proficiency with MS Word, Excel and PowerPoint
  • Advanced level of proficiency with project management strategies
  • Significant experience communicating verbally and in writing with all levels of managing including executives

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #GREEN

Skills Required

  • 5+ years hospital revenue cycle process knowledge gained through management or audit experience
  • 5+ years process auditing experience including data acquisition, analytics, workpaper preparation, professional report writing and process visualizations
  • Exceptional data analysis capabilities to interpret complex information and identify trends or risks
  • Expertise in researching and auditing to Federal and State regulations, payer guidelines, regulatory agency publications and industry standards for hospitals and physician practices
  • Professional designation such as Certified Healthcare Internal Auditor Professional (CHIAP), Certified Internal Auditor (CIA), or Certified Public Accountant (CPA)
  • Experience with Epic, MS4, Meditech, SMS Invision, Cerner, Star and other healthcare platforms or technologies
  • Advanced proficiency with Microsoft Word, Excel, and PowerPoint
  • Advanced level of proficiency with project management strategies
  • Significant experience communicating verbally and in writing with all levels of management including executives

What the Team is Saying

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
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