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, provides trends and analysis on payer issues, and conducts 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 the 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 queries and/or provide feedback to business partners as necessary.
• Update dashboards, trackers, and other process-related files in a timely manner.
• Provide training needs analysis and education as needed.
• Ensure accurate documentation of coaching sessions.
• Share payer issues and trends with 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.
• Ensure that her/his collections skills are intact thus a requirement to process a minimum of at 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 in real-time.
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives.

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.
• Proven adaptable 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 characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others.