Consultant - Payment Intelligence

Dallas, TX, United States

Description

Consultant - Payment Intelligence

AArete 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 Role

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 Do

Lead 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

Requirements

Minimum 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 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

Direct client interaction, including possible travel to client location

Applicants must be based in Chicago , IL and flexible to work from our Chicago office as needed

Must be legally authorized to work in the United States without the need for employer sponsorship

Benefits

Flexible 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

About 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 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 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.

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