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.

 

Primary Responsibilities:

Successful implementation and management of the training departmentTraining fresher, existing and experienced colleagues for all scopes of work in backend business of RCMDelivering training programs to employees using a variety of methods, including classroom instruction, e-learning and on-the-job trainingReview training needs and performance monthly basis and perform focus group, conduct feedback and monitor progress of the batches till they become productive as 100%Bottom quartile managementPlan and implement an effective training curriculum, content and automationCollaborate with management to identify training needs (TNI or TNA) for all employeesRegularly connect with ops, quality and training to enhance the training and identify the area of improvementMaintaining up-to-date knowledge of best practices in training and development and making recommendations for changes to training programs as requiredBe able to raise or track new hire process credentialsBe able to work on the accounts for the aligned process to have hands-on experience for better for experiential trainingLearn new or existing business as end to end and prepare or modifier the training curriculumBe able to align themselves with organization or team or client culture and mission, vision and valueBe well equipped in handling in-person and virtual trainingComply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

3+ years of experience in the US healthcare industry with acute and ambulatory billing3+ years of experience in healthcare revenue cycle management services, with understanding of upstream and downstreamIn-depth knowledge of denial management and appeal writing for both administrative and clinical denialsIn-depth knowledge of Acute and Ambulatory specialties with understanding of associated diagnosis, procedure and denialsComprehensive knowledge of UB04 claim form component, including proper inpatient coding, revenue codes, procedure codes, and regulatory requirementFamiliarity with insurance guidelines (Medicare, Medicaid, commercial payers) and their plansProficiency in understanding coding denials and code sets (ICD-10, CPT04, HCPCS) and understanding of medical recordsProven to work as AR representative and effectively implemented the experiential learning in the new hire batchesProven expertise in handling inpatient claims and understanding payment methodologies- DRG classifications, bundled payment models)Demonstrated ability to analyze AR claim as end to end and identify the root cause and faster resolutionDemonstrated ability to handle multiple geos - US/PR/PHL/INDProven solid analytical and problem-solving skillsProven excellent communication and leadership abilities

 

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.

 

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