AArete
Consultant - Payment Intelligence
AArete, El Segundo, California, United States, 90245
DescriptionConsultant - Payment IntelligenceAArete is one-of-a-kind when it comes to consulting firm culture.Why AArete?We are a
global,
innovative management and technology consulting firm
, with offices in the U.S., India, and the U.K
. Our name comes from the Greek word for excellence: "
Arete
." And excellence is exactly what we strive for.Our success starts with enriching and empowering our people. From robust career development planning to competitive life and wellness benefits,
AArete's
"Culture of Care" takes a holistic approach to the employee experience. At AArete, we encourage you to unlock your full potential by directly contributing to our mission and prioritizing space for personal development and fulfillment.The RoleMany 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
counterpartsUtilize 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
paymentIdentify areas of opportunity for Payment Intelligence by staying up to date on current events, changes in regulatory requirements and market trendsPrepare deliverables for final review with engagement
managerExercise excellent judgement and clear and direct communications in all aspects of your
workRequirementsMinimum 1.5+
years experience
in healthcare payment accuracy related role either in consulting, provider revenue cycle, a payment integrity/accuracy vendor, or within a payer organizationStrong professional communication skills including written, verbal, interpersonal and in-person presentation
expertiseExperience coaching and mentoring team
membersAdvanced proficiency utilizing Microsoft Excel and basic/ intermediate SQL for data
analysisStrong analytical, data analysis and interpretation skills; and ability to learn methodologies to identify client savings opportunities and put together an actionable business
caseBachelor's degree or equivalentDirect client interaction, including possible travel to client
locationMust be legally authorized to work in the United States without the need for employer
sponsorshipPreferred RequirementsBased in Chicago, IL and flexible to work from our Chicago office as neededBenefitsFlexible PTO, monthly half-day refuels, volunteer time off, 10 paid
holidaysOwn Your Day flexible work
policyCompetitive majority
employer-paid
benefits: Medical, Dental, Vision, 401K
MatchEmployee Stock Ownership PlanGenerous
maternity/paternity
leave optionsCompletely employer paid Life Insurance, STD, LTDCharitable contribution matching programNew client commission opportunities and referral bonus programVideo-free
FridaysBike share discount
programAbout 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
by
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 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
.AAP/
EEO StatementAll 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.#LI-DNI
#J-18808-Ljbffr
global,
innovative management and technology consulting firm
, with offices in the U.S., India, and the U.K
. Our name comes from the Greek word for excellence: "
Arete
." And excellence is exactly what we strive for.Our success starts with enriching and empowering our people. From robust career development planning to competitive life and wellness benefits,
AArete's
"Culture of Care" takes a holistic approach to the employee experience. At AArete, we encourage you to unlock your full potential by directly contributing to our mission and prioritizing space for personal development and fulfillment.The RoleMany 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
counterpartsUtilize 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
paymentIdentify areas of opportunity for Payment Intelligence by staying up to date on current events, changes in regulatory requirements and market trendsPrepare deliverables for final review with engagement
managerExercise excellent judgement and clear and direct communications in all aspects of your
workRequirementsMinimum 1.5+
years experience
in healthcare payment accuracy related role either in consulting, provider revenue cycle, a payment integrity/accuracy vendor, or within a payer organizationStrong professional communication skills including written, verbal, interpersonal and in-person presentation
expertiseExperience coaching and mentoring team
membersAdvanced proficiency utilizing Microsoft Excel and basic/ intermediate SQL for data
analysisStrong analytical, data analysis and interpretation skills; and ability to learn methodologies to identify client savings opportunities and put together an actionable business
caseBachelor's degree or equivalentDirect client interaction, including possible travel to client
locationMust be legally authorized to work in the United States without the need for employer
sponsorshipPreferred RequirementsBased in Chicago, IL and flexible to work from our Chicago office as neededBenefitsFlexible PTO, monthly half-day refuels, volunteer time off, 10 paid
holidaysOwn Your Day flexible work
policyCompetitive majority
employer-paid
benefits: Medical, Dental, Vision, 401K
MatchEmployee Stock Ownership PlanGenerous
maternity/paternity
leave optionsCompletely employer paid Life Insurance, STD, LTDCharitable contribution matching programNew client commission opportunities and referral bonus programVideo-free
FridaysBike share discount
programAbout 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
by
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 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
.AAP/
EEO StatementAll 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.#LI-DNI
#J-18808-Ljbffr