Optum Charge Edit/ Router Coordinator

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Exemption Status:

Schedule Details:

Scheduled Hours:

Shift:

Hours:

Cost Center:

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 16,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

I. Major Responsibilities:
1. The ACC serves on the team that designs, builds and validates the processes for their respective application(s).
2. Assists in building new data sets and testing of new functionality.
3. Works collaboratively with all Professional Billing (PB) areas (Accounts Receivable, Charge Review, Charge Entry, etc.) to develop and/or review edits and charge router logic, to address denials, new payer policies, CPT/ICD10 Revisions, Additions and Deletions, and any other changes that affect payments. 
4. Documents current and new workflows, rules and/or edits.
5. Works with the appropriate subject matter experts in design, build and testing of functionality.
6. Works collaboratively with the PB IT Team through understanding and compliance of the workflow decision process across all department to achieve positive outcomes related to editing and router logic.
7. Develops and documents internal procedures that will be used in conjunction with the application.
8. Performs analyses of workflows, data collection, report details, and other technical issues associated with the use of the software.
9. Utilizes in-depth knowledge of the software to serve as a liaison between end users and vendor.
10. Participates in regular communication with vendor’s team, reviewing the software, analyzing business operations, and working with the vendor and end users to tailor the application to the organization.
11. Provides application support during system upgrades.
12. Researches insurance carrier guidelines and policies as needed.
13. Troubleshoots problems or questions from users. 

II. Position Qualifications:

License/Certification/Education:
Required:
1. Bachelor's degree in Business Sciences, Health Sciences or in Information Systems
2. Certified Professional Coder. 

Experience/Skills:
Required:
1. Two years operational or clinical experience in an area related to Professional Billing. 
2. Demonstrated proficiency with information systems technology.
3. Demonstrated knowledge of revenue cycle management.
4. Demonstrated workflow process analysis and design.
5. Strong communication and interpersonal skills.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.