Senior Consultant - Payment Intelligence

Senior Consultant - Payment IntelligenceAArete is one-of-a-kind when it comes to consulting firm culture. 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.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 judgment and clear and direct communications in all aspects of your workRequirementsMinimum 4+ 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 needed

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