Join Optum, a global leader in healthcare technology, and contribute to improving millions of lives. Our mission is to connect people with the care, resources, and data they need for optimal health. We foster an inclusive culture, offer comprehensive benefits, and provide ample career development opportunities. Make a significant impact by advancing health optimization worldwide.

We are looking for a dedicated Operational Trainer to implement and manage our training programs. This role is crucial for enhancing the skills of our workforce and ensuring exceptional service delivery.

Design and deliver comprehensive training for new hires and existing staff across various backend RCM operations. Utilize diverse training methods, including classroom instruction and e-learning, to ensure effective knowledge transfer. Regularly assess training needs and employee performance, conducting feedback sessions and monitoring progress to achieve productivity goals. Develop and implement an effective training curriculum, content, and automation strategies. Collaborate with management to identify training needs (TNI/TNA) and continuously enhance training programs through feedback from operations and quality teams.

Maintain up-to-date knowledge of best practices in training and development, recommending program enhancements. Track new hire process credentials and gain hands-on experience in aligned accounts for enhanced experiential training. Develop a deep understanding of business processes to modify curriculum as needed. Align training content with organizational and client culture, mission, vision, and values. Skillfully conduct both in-person and virtual training sessions, adhering to all company policies and employment contract terms.

Extensive experience in the US healthcare industry, with a strong understanding of acute and ambulatory billing, as well as healthcare revenue cycle management. Proven experience as an AR representative, effectively applying experiential learning in new hire batches. Possess in-depth knowledge of denial management and appeal writing for both administrative and clinical denials. Comprehensive understanding of acute and ambulatory specialties, including associated diagnoses, procedures, and denials. Familiarity with the UB04 claim form, inpatient coding, revenue codes, and regulatory requirements is essential.

Expertise in handling inpatient claims and understanding payment methodologies like DRG classifications and bundled payment models. Proficiency in identifying coding denials and understanding code sets (ICD-10, CPT04, HCPCS) and medical records. Demonstrated ability to analyze AR claims end-to-end, identify root causes, and facilitate faster resolutions. Proven ability to manage multiple geographical regions (US/PR/PHL/IND) and strong analytical, problem-solving, communication, and leadership skills are required.