Understand edits and appropriate department procedures to effectively submit and/or correct errors on claims to the production standards of the department Utilize various resources such as third party publications, procedure manuals and participating contractual agreements, etc. to reconcile accounts Advanced knowledge and understanding to process third party rejections u

Regularly perform intakes, diagnostic evaluations, prepare and monitor treatment planning while engaging in appropriate client therapy practices and following guidance provided by one's supervisor Form effective therapeutic alliances, supporting each client's unique needs and goals, with the result in positively impacting client outcomes and retention Demonstrate advanced

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Perform full P&L financial modeling in support of all forecast cycles and bi weekly finance best estimates Analyze data and synthesize information in a way that highlights how business, market, and industry factors impact financial performance. Perform variance analysis and bridge financial results across all periods of interest Build and maintain highly automated and sca

Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants Establishes and maintains effective relationships with patients, care givers, and/or their legal representatives, IDT members, PCPs, other collaborating physicians/providers, and facility staff when applicable Performs an initi

Work with the StepWise software to configure rating algorithms, factor tables, and proposal outputs Work with the StepWise software to configure user experiences (including health plan sales and underwriting users) Work with the StepWise software to create business process / workflow automation Use Excel and SQL based systems to solve clients' business problems Present so

Careers with MedExpress. At MedExpress, we believe in delivering quality, convenient, affordable health care and exceeding our patients' expectations. Our neighborhood medical centers are open every day from 8 8 with a full medical team and no appointments necessary to help patients get in, get healthy, and get back to what's really important . We provide a broad scope of

Developing a testing automation strategy for our technology consulting practice, spanning both payer and provider markets Collaborate with stakeholders, including technical teams, to identify automation opportunities and prioritize initiatives Coordinate with vendors and other external parties to implement automation solutions Provide mentorship to a team of testing autom

Drives to appropriate DRG length of stay, level of care and patient experience, and reimbursement level of care for all patients Promotes patient advocacy in an independent care model Develops an optimal, l patient individualized, transition plan for patients with goal to reduce readmission and to support continued plan of care, regardless of next level of care Maintains

Lead the Case Management Operational teams for dedicated Optum client accounts for onsite delivery and outcomes. Accountable to meeting or exceeding operational and contract Service Level Agreements. Establishes and maintains service roadmaps to develop an integrated, innovative solution across all Care Management services. Provides input to consulting leadership for the

Escort Vendors such as Curvature, Hitachi/Dell, IBM, Cisco, Teradata, and others Protect Media Assets Oversee Dock Activity including sending and Receiving shipments & Pallets Be on time and ready to work consistently Keep documentation on what has transpired during tour of duty Represent the team and Optum with a can do attitude What are the reasons to consider working f

Identify appropriate assignment of CPT and ICD 10 Codes for outpatient Ambulatory Observation services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits Understand the Medicare Ambulatory Payment Classification (APC) codes Abstra

Manage day to day RCM A/R and cash application process striving for operational excellence. Aid in continually improving our cash flow/DSO through effective accounts receivable and collections Ensure overall RCM A/R and Cash App processes are operating effectively and continually improving our financial and operating controls Accountable for managing RCM financial activit

Responsible for completing the financial clearance process and creating the first impression of Optum services to patients, their families, and other external customers. You will articulate information in a manner that patients, guarantors, and family members understand and will know what to expect regarding their financial responsibilities. Work in a team environment wit

Partnering with Optum Bank's leaders and subject matter experts and with Optum Financial delivery teams with focus on multiple Optum Bank strategic delivery components Assist with managing project intake and infrastructure build out to ensure project is ready to be scheduled and resourced for delivery Work closely with business, technology and PMO to resolve project sched