%3Cp style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EOptum 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%3Cstrong%3E Caring. Connecting. Growing together.%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%0A%3Cp style=%22font-family: Tahoma;%22%3E%3C/p%3E%0A%3Cp style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3E%3Cstrong%3EPrimary Responsibilities:%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%0A%3Cul%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3ESuccessful implementation and management of the training department%26nbsp;%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3ETraining fresher, existing and experienced colleagues for all scope of work in backend business of RCM%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EDelivering training programs to employees using a variety of methods, including classroom instruction, e-learning and on-the-job training%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EReview training needs and performance monthly basis and perform focus group, conduct feedback and monitor progress of the batches till they become productive as 100%%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EBottom quartile management%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EPlan and implement an effective training curriculum, content and automation%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3ECollaborate with management to identify training needs (TNI/TNA) for all employees%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3ERegularly connect with ops, quality and training to enhance the training and identify the area of improvement%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EMaintaining up-to-date knowledge of best practices in training and development and making recommendations for changes to training programs as required%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EBe able to raise/track new hire process credentials%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EBe able to work on the accounts for the aligned process to have hands-on experience for better for experiential training%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3ELearn new / existing business as end to end and prepare / modifier the training curriculum%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EBe able to align himself/herself with organization/ team / client culture and mission, vision and value%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EBe well equipped in handling in-person and virtual training%3C/span%3E%3C/span%3E%3C/li%3E%0A%3Cli style=%22font-family: Tahoma;%22%3E%3Cspan style=%22font-family: tahoma, arial, helvetica, sans-serif;%22%3E%3Cspan style=%22font-size: 10px;%22%3EComply 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%3C/span%3E%3C/span%3E%3C/li%3E%0A%3C/ul%3E
Required Qualifications:
7+ years of experience in the US healthcare industry with Acute Speciality and Hospital Billing
10+ years of experience in healthcare revenue cycle management services, with understanding on upstream and downstream
Experience in RCM Operations/Quality/Training can apply
Worked as AR representative and effectively implemented the experiential learning in the new hire batches
In-depth knowledge of denial management and appeal writing for both administrative and clinical denials
In-depth knowledge of Acute and Ambulatory specialties with understanding of associated diagnosis, procedure and denials
Comprehensive knowledge of UB04 claim form component, including proper inpatient coding, revenue codes, procedure codes, and regulatory requirement
Familiarity with insurance guidelines (Medicare, Medicaid, commercial payers) and their plans
Expertise in handling inpatient claims and understanding payment methodologies- DRG classifications, bundled payment models)
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
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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