Consultant - Payment Intelligence
El Segundo, CA  / Denver, CO  / Chicago, IL  / New York, NY  / Dallas, TX  / Vienna, VA ...View All
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Posted 3 days ago
Job Description
Description

Consultant- PaymentIntelligence
AArete is one of a kind when it comes to consulting firm culture.
Many vendors provide on-going payment integrity services; however,AArete'sPayment Intelligenceensures erroneous paymentsare identified, understood,recoupedand rectified to prevent them in the future. Payment Intelligenceaddresses provider billing andhealth plan payment inaccuraciesresulting from issues with payment policies, provider contracts, provider data, covered benefits, member eligibility and prior authorizations.
In this role, the individual will be responsible for leading Payment Intelligencein client delivery. The position will reportintoa Payment IntelligenceManager. The individual will be the subject matter expert on practices to help our clients ensure proper claims paymentthrough the use of(1) claims analytics, (2) process improvements, (3) integration of automation/technology, and (4) configurations setups. This role will also support the internal development of Payment Intelligence initiatives.
Work you'lldo
  • Lead the development, identification and root causeof payment accuracy opportunities through enhancing tactics and communicate/coordinate remediation with clientcounterparts
  • Utilize claims analytics to uncover payment accuracy opportunities through your knowledge of standard payment methodologies including Prospective Payment Systems (IPPS/OPPS), fee for service, Groupers, RUG, etc.
  • Support the advancement ofAArete'sPayment Intelligenceinitiatives to drive greater automation to claimspayment
  • Identify areas of opportunity for Payment Intelligence by staying up to date on current events, changes in regulatory requirements and market trends
  • Prepare deliverables for final review with engagementmanager
  • Exercise excellent judgement and clear and direct communications in all aspects of your work
Requirements
  • Minimum1.5+years experiencein healthcare payment accuracy related role either in consulting, provider revenue cycle, a payment integrity/accuracy vendor, or within a payer organization
  • Strong professional communication skills including written, verbal, interpersonal and in-person presentationexpertise
  • Experience coaching and mentoring teammembers
  • Advanced proficiency utilizing Microsoft Excel andbasic/ intermediateSQLfor dataanalysis
  • Stronganalytical, data analysis andinterpretationskills;and ability to learnmethodologiesto identify client savings opportunities and put together an actionable businesscase
  • Bachelor's degree or equivalent
Why AArete?
We are an innovativemanagementand technology consulting firm. In Greek, our namesignifies"excellence"- due to this the bar is set high at AArete.We believe that any organization can succeed by enriching and empowering its people - starting with our own team members. Our distinctive Culture of Care compels us to collaboratively solve problems thateffectpurposeful change for our clients and community.
We're growing fast, and you will too. At AArete, we want you to realize your full potential by havingdirectimpact delivering on our mission while prioritizing space for personal development and fulfillment.
At AArete, you'll collaborate with team members across the globe.While we have offices in the US, India, and the UK, based on your preference and client needs,AAretiansmay work on-premises and/or remotely.
About AArete
AArete is a global management and technology consulting firm specializing in strategic profitability improvement, digital transformation, and advisory services. Our cross-industry solutions are powered through modern technology, market intelligence, and big data to drive purposeful change and actionable outcomes.
AArete is guided by our deeply embedded principles: Excellence, Passion, Loyalty to Clients, Stewardship, Family, Community, Sustainability, and Inclusion.
We are proud to have earned a Great Place to Work Certificationand namedas one of America's Best Management Consulting Firms by Forbes,Vault's Top 50 Firms to Work For, Crain's Chicago Business Fast 50, Inc 5000's Fastest Growing Firms, Consulting Magazine's Fastest Growing Firms.
Check out some of ourAAwesomeBenefits
  • Flexible PTO, monthly half-day refuels, volunteer time off, 10 paidholidays
  • Own Your Day flexible workpolicy
  • Competitive majority employer paid benefits: Medical, Dental, Vision, 401KMatch
  • Employee Stock Ownership Plan
  • Generous maternity / paternity leave options
  • Completely employer paid Life Insurance, STD, LTD
  • Charitable contribution matching program
  • New client commission opportunities and referral bonus program
  • Video free Fridays
  • Bike share discount program
  • Home office allowance
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

 

Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
1 to 5 years
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