AArete
Senior Consultant – Payment Intelligence
AArete, Chicago, Illinois, United States, 60290
DescriptionSenior Consultant - Payment Intelligence
AArete is one-of-a-kind when it comes to consulting firm culture.
Why AArete?
We are aglobal,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 Role
Many vendors provide on-going payment integrity services; however,AArete'sPayment Intelligence ensures erroneous payments are identified, understood,recoupedand 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 reportintoa Payment Intelligence Manager. 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'll Do
Lead the development, identification and root cause of payment accuracy opportunities through enhancing tactics and communicate/coordinate remediation with clientcounterpartsUtilize 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 Intelligence initiatives to drive greater automation to claimspaymentIdentify 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 engagementmanagerExercise excellent judgement and clear and direct communications in all aspects of yourworkRequirements
Minimum 4+years experiencein 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 presentationexpertiseExperience coaching and mentoring teammembersAdvanced proficiency utilizing Microsoft Excel and basic/ intermediate SQL for dataanalysisStrong analytical, data analysis and interpretation skills; and ability to learn methodologies to identify client savings opportunities and put together an actionable businesscaseBachelor's degree or equivalentDirect client interaction, including possible travel to clientlocationMust be legally authorized to work in the United States without the need for employersponsorshipPreferred Requirements
Based in Chicago, IL and flexible to work from our Chicago office as neededBenefits
Flexible PTO, monthly half-day refuels, volunteer time off, 10 paidholidaysOwn Your Day flexible workpolicyCompetitive majorityemployer-paidbenefits: Medical, Dental, Vision, 401KMatchEmployee Stock Ownership PlanGenerousmaternity/paternityleave optionsCompletely employer paid Life Insurance, STD, LTDCharitable contribution matching programNew client commission opportunities and referral bonus programVideo-freeFridaysBike share discountprogramAbout 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 poweredbymodern 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 Statement
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.
#J-18808-Ljbffr
AArete is one-of-a-kind when it comes to consulting firm culture.
Why AArete?
We are aglobal,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 Role
Many vendors provide on-going payment integrity services; however,AArete'sPayment Intelligence ensures erroneous payments are identified, understood,recoupedand 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 reportintoa Payment Intelligence Manager. 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'll Do
Lead the development, identification and root cause of payment accuracy opportunities through enhancing tactics and communicate/coordinate remediation with clientcounterpartsUtilize 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 Intelligence initiatives to drive greater automation to claimspaymentIdentify 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 engagementmanagerExercise excellent judgement and clear and direct communications in all aspects of yourworkRequirements
Minimum 4+years experiencein 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 presentationexpertiseExperience coaching and mentoring teammembersAdvanced proficiency utilizing Microsoft Excel and basic/ intermediate SQL for dataanalysisStrong analytical, data analysis and interpretation skills; and ability to learn methodologies to identify client savings opportunities and put together an actionable businesscaseBachelor's degree or equivalentDirect client interaction, including possible travel to clientlocationMust be legally authorized to work in the United States without the need for employersponsorshipPreferred Requirements
Based in Chicago, IL and flexible to work from our Chicago office as neededBenefits
Flexible PTO, monthly half-day refuels, volunteer time off, 10 paidholidaysOwn Your Day flexible workpolicyCompetitive majorityemployer-paidbenefits: Medical, Dental, Vision, 401KMatchEmployee Stock Ownership PlanGenerousmaternity/paternityleave optionsCompletely employer paid Life Insurance, STD, LTDCharitable contribution matching programNew client commission opportunities and referral bonus programVideo-freeFridaysBike share discountprogramAbout 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 poweredbymodern 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 Statement
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.
#J-18808-Ljbffr