Join Optum, a global healthcare organization dedicated to improving lives through technology and compassionate care. We connect individuals with the resources they need to thrive, fostering a culture of inclusion and professional growth. Our mission is to advance health optimization on a global scale. We invite you to be a part of a team that is Caring, Connecting, and Growing together.

This role focuses on the accounts receivable aspects of revenue cycle operations, requiring a deep understanding of standard operating procedures and proactive communication of insights to leadership. If you have a passion for healthcare and meet the qualifications, we encourage you to explore this exciting opportunity.

Your primary duties will involve meticulously reviewing outstanding insurance balances to identify and resolve claim payment issues. This includes coordinating effectively with payers, patients, and clients. You'll analyze and trend data to propose solutions that enhance first-pass claim success and reduce the overall age of accounts receivable.

Additional responsibilities include gaining a comprehensive understanding of the entire accounting cycle and claim lifecycle. You will ensure all workflow items are completed within established turnaround times and quality standards. A key aspect of this role is performing claim-level analysis of Explanation of Benefits (EOBs) and denials, identifying trends that impact revenue and drive process improvements. You will also be expected to perform other duties as assigned and adhere to all company policies and employment contract terms.

To be successful in this position, you should possess a Graduate degree (10+2+3) or a B.Tech, along with an MBA, and relevant AR experience. A minimum of 18 months of experience in AR Calling is essential.

You will need hands-on expertise in Physician Billing, specifically with the CMS 1500 claim form, and a strong grasp of Denial Management within the RCM/AR domain. Knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers) is crucial, as is an in-depth understanding of HIPAA regulations and privacy laws.

Excellent communication skills in American English with a neutral accent are required. Proficiency in MS Office Suite, particularly Excel and Outlook, is necessary. You must demonstrate proven ability in effective communication, sound judgment, critical thinking, problem identification and resolution, efficient typing, a strong work ethic, and a high level of professionalism focused on client and patient satisfaction.