Director Of Software Engineering
CurrentOptum Insights - Technology Engineering - Healthcare Claim Administration & Payment Accuracy- Advanced Communication Engine (ACE) - Claims Edit System (CES) Claim Payment Accuracy- Claims Manager (CM) Claim Admin- Provider Communication Gateway (PCG)Lowering the cost of healthcare by reducing medical billing overhead via transparent Payer-Provider Communication. We develop tools that improve medical coding and claim preparation accuracy, providing the ability for Provider systems to talk to Payer systems and communicate missing or incorrect items on the claim. The industry term is “Edit”. It is like spelling and grammar check for medical claims. When these items are corrected before submission Acceptance/Approval is more likely thus reducing the administrative costs of reworking the claim.