The Role
The Subject Matter Expert ensures process accuracy in hospital revenue cycle management, conducts audits, provides training, and supports collection efforts.
Summary Generated by Built In
Requisition Number: 2349051
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:
Required Qualifications:
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.
#NJP
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:
- As the position Implies, they should be the expert to the process they belongs to
- Ensures that they 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 they 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 regard 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:
- Work experience:
- 2+ years of experience in Hospital Revenue Cycle Management
- Thorough understanding of insurance policies and procedures
- Working knowledge of medical terminology
- Proven basic computer skills, must understand Excel
- Proven excellent written and verbal communication
- Undergone process training and pass ramp certification
- Technical Knowledge
- Proven high sense of responsibility and accountability; Takes ownership and initiative
- Proven excellent communication capability; persuasive, inclusive, and encouraging; the ability to listen and understand; Ability to elicit cooperation from a variety of resources
- Proven adaptable and flexible, with the ability to handle ambiguity and sometimes changing priorities
- Proven professional demeanor and positive attitude; customer service orientation
- Demonstrated ability to think and act; decisiveness, assertiveness, with ability to achieve results quickly
- Demonstrated ability to learn, understand, and apply new technologies, methods, and processes
- Demonstrated ability to recognize necessary changes in priority of tasks and allocation of resources, and bring them to the attention of Optum Leadership, as required
- Demonstrated ability to be a self-starter and work independently to move projects successfully forward
- Demonstrated ability to work with a variety of individuals in managerial and staff level positions
- Demonstrated ability 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)
- Demonstrated 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.
#NJP
Skills Required
- 2+ years of experience in Hospital Revenue Cycle Management
- Thorough understanding of insurance policies and procedures
- Working knowledge of medical terminology
- Proven basic computer skills, must understand Excel
- Proven excellent written and verbal communication skills
- Undergone process training and pass ramp certification
Optum Compensation & Benefits Highlights
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Healthcare Strength — Health coverage offers multiple plan types with employer HSA contributions, in‑network preventive care at 100%, and included 24/7 virtual visits, alongside dental and vision options. This breadth allows predictable copay choices or tax‑advantaged HSA designs to fit different usage needs.
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Retirement Support — Retirement programs include a 401(k) with employer match eligibility and full vesting over time plus an Employee Stock Purchase Plan at a discount. Together these elements support long‑term savings and ownership.
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Parental & Family Support — Family supports include six weeks paid parental leave, paid caregiver leave, adoption assistance, and subsidized Bright Horizons back‑up care. Emotional well‑being resources like a premium Calm subscription and a 24/7 EAP complement these supports.
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The Company
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
