Job Description

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. Primary Responsibilities:

• Successful implementation and management of the training department
• Training fresher, existing and experienced colleagues for all scope of work in backend business of RCM
• Delivering training programs to employees using a variety of methods, including classroom instruction, e-learning and on-the-job training
• Review 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 management
• Plan and implement an effective training curriculum, content and automation
• Collaborate with management to identify training needs (TNI/TNA) for all employees
• Regular connects with ops, quality and training to enhance the training and identify the area of improvement
• Maintaining up-to-date knowledge of best practices in training and development and making recommendations for changes to training programs as required
• Be able to raise/track new hire process credentials
• Be able to work on the accounts for the aligned process to have hands-on experience for better for experiential training
• Learn new / existing business as end to end and prepare / modifier the training curriculum
• Be able to align himself/herself with organization/ team / client culture and mission, vision and value
• Be well equipped in handling in-person and virtual training
• 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

Eligibility To apply to an internal job, employees must meet the following criteria:

• Grade 25 and 26 can apply
• Grade 25 will move to 26, Grade 26 will move laterally
• Preferably minimum duration of 12 months of continuous service in their current grade and position. If employee has not completed one year in current role, please discuss interest with your reporting manager and seek alignment
• Performance rating in the last common review cycle of ?Meets Expectations? or higher
• Not be on any active CAP (Corrective Action Plan) or active disciplinary action

Required Qualifications:

• 10+ years of experience in the US healthcare industry with acute and ambulatory billing
• 8+ years of experience in healthcare revenue cycle management services, with understanding on upstream and downstream
• Worked as AR representative and effectively implemented the experiential learning in the new hire batches
• Familiarity with insurance guidelines (Medicare, Medicaid, commercial payers) and their plans
• In-depth knowledge of denial management and appeal writing for both administrative and clinical denials
• Expertise in handling inpatient claims and understanding payment methodologies- DRG classifications, bundled payment models)
• Comprehensive knowledge of UB04 claim form component, including proper inpatient coding, revenue codes, procedure codes, and regulatory requirement
• In-depth knowledge of Acute and Ambulatory specialties with understanding of associated diagnosis, procedure and denials
• Proficiency in understanding coding denials and code sets (ICD-10, CPT04, HCPCS) and understanding of medical record
• Demonstrated ability to analyze AR claim as end to end and identify the root cause and faster resolution
• Demonstrated ability to handle multiple geos- US/PR/PHL/IND
• Proven solid analytical and problem-solving skills
• Proven excellent communication and leadership abilities

Preferred Qualification:

• Any certification in the field of coding and AR
• Experiential knowledge of MS4/Cerner/Invision/EPIC/eFR will be added advantage

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