Senior Solution Specialist, Payment Intelligence

Description

Senior Solution Specialist, Payment Intelligence

AArete is one-of-a-kind when it comes to consulting firm culture.

We're 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.

AAretians (our team members) are leaders at every level. You are encouraged to unlock your full potential by directly contributing to our mission and prioritizing space for personal development and fulfillment.

The Role

Health plans face continued challenges in reimbursing claims on-time and accurately. AArete's Payment Intelligence goes beyond typical payment integrity to ensure erroneous and inefficient payments are identified, rectified, and recouped to prevent them in the future.

In this role, the individual will be responsible for delivering claims analytics and post-pay data mining edits for client engagements . The position will report to a Payment Intelligence Manager. The individual will be the subject matter expert on strategies 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.

Work You'll Do

• Lead the development, identification and root cause of payment accuracy opportunities through remediation with client counterparts
• Utilize analytics to uncover claims payment opportunities through your knowledge of standard payment methodologies including Prospective Payment Systems (IPPS / OPPS), fee for service, Groupers, RUG, etc.
• Support the advancement of automation
• S taying up to date on current events, changes in regulatory requirements and market trends impacting health plan reimbursement
• Prepare client ready deliverables
• Exercise excellent judgement and clear and direct communication in all aspects of your work
• Other duties as assigned

Requirements

Preferred Requirements

Research and interpretation of healthcare policies and regulations

I nterpretation of provider contract terms and pricing methodologies, including fee schedules, per diem, DRGs, cost-plus, and outlier payments

Compensation & Benefits

The estimated base salary range for this position is $ 105,000 - $125,000 . In addition to this base salary, individuals may be eligible for an annual discretionary bonus. This range is a part of a competitive, total compensation package together with our majority employer-paid benefits, and incentive pay for eligible roles. Please note that this range is a guideline and individual total compensation may vary due to numerous factors including but not limited to experience level, certifications, and other relevant business considerations.

AArete will accept applications until the position is filled. The job posting will be removed once the role is no longer available.

We put humans at the center of our work

We're a global management and technology consulting firm specializing in strategic profitability improvement, digital transformation, and strategy & change for clients. Our cross-industry solutions are powered by a digital-first mindset, market intelligence, and data-driven approach to deliver purposeful change, actionable insights, and guaranteed results.

But what sets us apart is our people. We are guided by our deeply embedded guiding principles : Excellence, Passion, Loyalty to Clients, Stewardship, Family, Community, Sustainability, and Inclusion.

And we've been recognized as a top firm to work for by companies like Forbes, Top Workplaces Chicago Tribune, and Consulting Magazine.

We've earned a Great Place to Work Certification and been named a World's Best Management Consulting Firm by Forbes, Vault's Top 50 Firms to Work For , Crain's Chicago Business Fast 50, Inc 5000's Fastest Growing Firms , and Consulting Magazine's Fastest Growing Firms .

Learn more about our award-winning culture

We are an Equal Employment Opportunity Employer

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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