Senior Consultant - Healthcare Claims Analytics
- Posted: over a month ago
Senior Consultant – Healthcare Claims Analytics
AArete is one of a kind when it comes to consulting firm culture. Join us!
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 with dotted lines to the client engagement managers. 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.
At AArete we’re successfully embracing working in a flexible work environment. We have offices in many locations such as Chicago, New York, Los Angeles, Dallas, and DC. Based on preference, AAretians have the opportunity to work remotely, visit nearby office or client location.
We are fast growing strategy, operations and technology consulting firm, because of this the bar is set high at AArete. AArete is guided by our deeply embedded principles: Excellence, Passion, Loyalty to Clients, Stewardship, Family, Community, Sustainability, and Inclusion. We strive to continually improve our work environment to allow for high team member engagement and ability to be successful. Join the company named in Vault’s Top 50 Firms to Work For, Crain's Chicago Business Fast 50 for a 3rd year, Inc 5000’s Fastest Growing Firms list for the 4th consecutive year, Consulting Magazine's Fastest Growing Firms for the 4th consecutive year and Forbes Magazine’s Best Consulting Firms in America list of 2021.
- Exciting variety of clients and business challenges – from the largest firms in the world to mid-size tech growth companies to colleges and universities
- Culture – collaborative, focused on career/professional development, plentiful opportunities, exciting, and fun!
- Competitive Pay and Benefits – competitive salary, unlimited PTO, 401K match, Employee Stock Ownership Plan
Work you’ll do
- Lead the development, identification and root causing 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
- Minimum 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
- 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
- Enthusiasm for joining a fast-paced, high growth company and be a part of the business architecture of technology applications and tools
- Interest in taking advantage of career advancement opportunities within AArete and a growing solution offering
- Bachelor’s degree or equivalent
- Willingness and ability to travel commensurate with industry standards – typical travel in this role can be 50% - 90%+, however as we adjust to a Post-COVID environment, we anticipate travel to be limited and reduced