Subject Matter Expert

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

This function is responsible for providing AR billing and/or collections expertise to the team for optimum reduction AR,  and/or FBNS,  and working with payers to improve or maintain cash goals set. Position in this function assists staff in their query, provide trends and analysis on payer issues, and conduct refreshers when needed

The position carries out his/her duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of organization and carries out the Vision and Mission of the organization

Primary Responsibilities:

• As the position Implies, candidate should be the expert to the process that belongs to
• Ensures that he/she is current as it relates to process updates
• Attend scheduled meeting and calibration sessions
• Review audit markdown and conduct error analysis and process related coaching including root cause analysis
• Complete internal accounts audit as deemed required
• Respond to query and/or provide feedback to business partners as necessary
• Update dashboards, trackers, other process related files in a timely manner
• Provide training needs analysis and education as needed
  • Provides Quality talks and related updates
• Ensure accurate documentation of coaching sessions
• Share payer issues and trends to supervisors and managers.
• Provide support in creating training materials, new hire training (practical sessions and OJT) and refresher courses as deemed necessary
• Acts as POC in the absence of the supervisor.
  • Submit rebuttals to failed audits in the absence of the supervisor
  • Send out the inventory plan for the team in the absence of the supervisor
• Ensure that her/his collections skill are intact thus a requirement to process minimum of least 10 accounts/week for the process she/he belongs to. The requirement may increase depending on the need to keep the inventory at a manageable level
• Strictly implement company policies and guidelines
• Request needed learning from Onshore training team
• Provide floor/virtual support to ensure that collectors are assisted real time
• Comply 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:

• Undergo process training and pass ramp certification
• 2+ years of experience in Hospital Revenue Cycle Management
• Working knowledge of medical terminology
• Thorough understanding of insurance policies and procedures
• Basic computer skills, must understand Excel
• Proven excellent written and verbal communication
• Proven high sense of responsibility and accountability; Takes ownership and initiative
• Proven ability to think and act; decisiveness, assertiveness, with ability to achieve results quickly
• Proven excellent communication capability; persuasive, inclusive, and encouraging; the ability to listen and understand; Ability to elicit cooperation from a variety of resources
• Provendaptable and flexible, with the ability to handle ambiguity and sometimes changing priorities
• Proven professional demeanor and positive attitude; customer service orientation
• Proven ability to learn, understand, and apply new technologies, methods, and processes
• Proven ability to recognize necessary changes in priority of tasks and allocation of resources, and bring them to the attention of Optum Leadership
• Proven ability to be a self-starter and work independently to move projects successfully forward
• Proven ability to work with a variety of individuals in managerial and staff level positions
• Proven to possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Optum and our client organization(s)
• Demonstrates a positive leadership shadow by shaping positive behaviors in areas of influence, building integrity, influencing our values and creating a healthy, high-performance environment

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.