Optum · 1 week ago
Revenue Assurance SME - Remote
United States
Full-time
Remote
Mid Level
$73K/yr - $130K/yr
3+ years expOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Revenue Assurance SME is primarily responsible for the development, maintenance, communication, and audit functions of a standard, regulatory-focused Corporate Charge Description Master (CDM), working collaboratively to provide value to customers.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Audit the Corporate Standard CDM/client CDMs to ensure compliance with regulatory agencies and applicable policies
Thinks outside the box to discover and present new ways to utilize and analyze large and complex datasets
Uses data visualization techniques to drive collaborative, data-driven decision making with Optum and Client leadership
Makes decisions that require significant analysis and investigation with solutions requiring original thinking
Maintains current knowledge in applicable rules and regulations and disseminates relevant information to clients and other areas of the Revenue Cycle
Interacts with leadership, department managers and regional facility staff members regarding alignment and adherence to corporate standard, regulatory compliance, and reimbursement issues
Responds to customer inquiries professionally and can analyze revenue cycle questions and issues to resolution
Ability to prioritize workload and balance numerous projects simultaneously while delivering timely results
Creates and effectively delivers regulatory guidance and educational materials to internal and external customers
Take initiative to identify system and / or operational problems and participate in the development of solution for improvement to billing functions for client facilities
Serves as a resource to EHR / implementation project team members
Demonstrate flexibility and willingness to support the changing needs and priorities of the department and organization
Qualification
Required
Revenue Cycle related credential of any type (AAPC, AHIMA, HFMA, NAHRI etc.) or the ability to obtain within the first 12 months of employment
3+ years of experience in Medicare/CMS Regulatory Guidance
3+ years of work experience in a health care environment with focus in billing, coding, revenue cycle process, compliance, or CDM type work
3+ years of experience understanding and employing fundamental concepts, practices, and procedures relating to healthcare facilities and their operations
3+ years of experience with financial and regulatory risk involving facility and professional charging practices
3+ years of experience of business operations and in-house business systems
Proven advanced understanding and capabilities in Microsoft Excel
Proven ability to communicate analysis, including trends and opportunities to clients and the business both verbally and through writing/visualization
Proven solid problem-solving skills with a structured, process-oriented approach
Proven expertise in continuous process improvement and root cause analysis
Proven ability to manage multiple tasks, set priorities, scheduling, and meet deadlines
Preferred
Certification or extensive experience with Excel VBA Analytics
Extensive knowledge of MS programs e.g., Word, Access, PowerPoint, Loop
Knowledge of Epic, Cerner, or other Clinical/Financial systems
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
Company data provided by crunchbase