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:

• Maintaining production with accuracy of work following business workflow
• Demonstrated ability to exceed performance targets
• Analysis data to identify process gaps, prepare reports
• Responsible for daily TAT and quality as per SLA
• To ensure client satisfaction by the delivery of quality services and quality products
• Assisting Operations team to identify the potential areas of improvement and actively participate in improvement initiatives
• Accurate and timely documentation of claims data
• Coordinate with the Team to identify process improvement opportunities
• Monitor, measure and report Team performance metrics and implement Team incentive programs
• Routinely analyze quality results to report error trends
• Identify root causes of errors and opportunities for defect reduction
• Analyze and develop overall improvement plans (department and individual)
• Administrative responsibilities as assigned
• 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:

• 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
• SG23 and SG24 can apply

Required Qualifications:

• Graduate degree or equivalent experience
• Bachelorxe2x80x98s Degree
• 3+ years of experience in US Healthcare & RCM BPO industry
• 2+ years knowledge of Accounts receivable & Denial Management in RCM
• 1+ years collections experience in other aspect of RCM (Ambulatory, & Acute preferable)
• Hands on experience in US Healthcare Revenue Cycle Management - AR Calling and Denial Management
• Hands-on experience in Allscripts and IDX, EPIC applications
• US Healthcare - Provider & Physician experience
• Good in Denial Management
• Knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials
• Ability to ensure adherence to state and federal compliance policies
• Good working knowledge of computers, typing skills and good proficiency in MS Office
• Demonstrate the ability to communicate effectively both verbally and in writing
• Great problem-solving skills and good listening skills (Attention to details)
• Knowledge about CARC & RARC Codes to understand the denial and patient responsibilities codes on EOB
• Solid Understanding of medical billing term such as Co-pays, Coinsurance, Deductibles, Allowable amount, Contractual adjustments, Out-of-network and In-network processing, Retractions/Recoupments, Interest payments, Collection agency adjustments, NF and WC payments and Zero claims
• Capability to handle onshore SMEs individually
• Proven excellent Interpersonal skills
• Solid Proficiency in MS Office
• Open to Night Shifts and work on Indian Holidays/ WFO & WFH

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.