Senior Consultant – Payment Intelligence

Senior Consultant – Payment IntelligenceAArete is one of a kind when it comes to consulting firm culture.Many vendors provide on-going payment integrity services; however, AArete’s Payment Intelligence ensures erroneous payments are identified, understood, recouped and rectified to prevent them in the future. Payment Intelligence addresses provider billing and health plan payment inaccuracies resulting 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 Intelligence in client delivery. The position will report into a Payment Intelligence Manager. The individual will be the subject matter expert on practices to help our clients ensure proper claims payment through 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’ll doLead the development, identification and root cause of payment accuracy opportunities through enhancing tactics and communicate/coordinate remediation with client counterparts.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 of AArete’s Payment Intelligence initiatives to drive greater automation to claims payment.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 engagement manager.Exercise excellent judgement and clear and direct communications in all aspects of your work.RequirementsMinimum 4+ years experience in 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 presentation expertise.Experience coaching and mentoring team members.Advanced proficiency utilizing Microsoft Excel and basic/intermediate SQL for data analysis.Strong analytical, data analysis and interpretation skills; and ability to learn methodologies to identify client savings opportunities and put together an actionable business case.Bachelor’s degree or equivalent.Why AArete?We are an innovative management and technology consulting firm. In Greek, our name signifies “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 that effect purposeful 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 having direct impact 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, AAretians may work on-premises and/or remotely.About AAreteAArete 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 Certification and named as 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 our AAwesome BenefitsFlexible PTO, monthly half-day refuels, volunteer time off, 10 paid holidays.Own Your Day flexible work policy.Competitive majority employer paid benefits: Medical, Dental, Vision, 401K Match.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.

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