Subject Matter Expert
Company: Optum (UnitedHealth Group)
Job Title: Subject Matter Expert (SME)
Location: Chennai, Tamil Nadu
Job Category: Billing / Revenue Cycle Management
Experience Required: 2+ Years
Employment Type: Full-time
Job Summary
Optum is hiring a Subject Matter Expert (SME) to support Hospital Revenue Cycle Management operations by providing process expertise, quality monitoring, training support, audit analysis, and real-time guidance to operational teams. The role involves acting as a process expert, handling escalations, supporting team performance improvement, and ensuring compliance with billing workflows and organizational standards.
Key Responsibilities
Act as the process expert (SME) for assigned revenue cycle operations.
Stay updated with process changes, payer guidelines, and workflow updates.
Attend calibration meetings, process reviews, and scheduled team discussions.
Review audit markdowns, conduct root cause analysis, and provide process coaching.
Perform internal account audits and quality reviews.
Respond to operational queries and provide feedback to business teams.
Maintain dashboards, trackers, and process documentation accurately.
Conduct training needs analysis and support employee skill development.
Deliver quality sessions, process updates, and knowledge-sharing discussions.
Maintain documentation of coaching sessions and performance improvement activities.
Share payer-related issues, operational trends, and process gaps with leadership.
Assist in:
Training material creation
New hire training
Practical sessions / OJT
Refresher training
Act as Point of Contact (POC) in the supervisor’s absence.
Submit audit rebuttals when required.
Support inventory planning and workload allocation.
Process minimum assigned accounts to maintain operational productivity.
Provide real-time floor/virtual support to collectors and team members.
Ensure compliance with company policies, quality standards, and operational procedures.
Required Qualifications
2+ years of experience in Hospital Revenue Cycle Management (RCM)
Strong understanding of:
Insurance policies and procedures
Medical terminology
Billing operations
Basic to intermediate Microsoft Excel proficiency
Excellent written and verbal communication skills
Completion of required process training and ramp certification
Required Skills
Technical Skills
Hospital Revenue Cycle Management
Medical Billing Operations
Insurance Claims Process
Account Auditing
Quality Analysis
Root Cause Analysis
Training & Coaching
Performance Monitoring
Process Documentation
Dashboard / Tracker Management
Microsoft Excel
Medical Terminology
Soft Skills
Strong ownership and accountability
Leadership and team support mindset
Communication and interpersonal skills
Coaching and mentoring ability
Adaptability and flexibility
Customer service orientation
Decision-making and problem-solving
Ability to handle changing priorities
Independent working capability
Process improvement mindset
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