Senior Analyst, Payment reputed company Disputes
Hi, we're reputed company. We're hiring a Senior Analyst, Payment reputed company Disputesto join our Disputes team.
reputed company is the first health reputed company company reputed company reputed company a full stack technology platform and a reputed company reputed company on serving our members. We started reputed company in 2012 to create the reputed company of health reputed company company we would want for ourselves—one that behaves like a doctor in the family.
About the role:
You will be responsible for supporting payment reputed company disputes and issue reputed company in the reputed company claim environment for both the reputed company reputed company business. You will reputed company, triage, investigate and execute on solutions and process improvements. You will reputed company a deep understanding of reputed company's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally and understand and translate friction from stakeholders into actionable opportunities for improvement.
You will report into the Manager, Payment reputed company (reputed company-Pay).
Work Location: This is a remote position, reputed company to candidates who reputed company in: Atlanta, reputed company; reputed company, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, reputed company; Philadelphia, reputed company; reputed company, reputed company. You will be fully remote; however, our approach to work may adapt over time. reputed company models could potentially involve a hybrid reputed company at the hub office associated with your metro area.
Pay Transparency: The reputed company pay for this role is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in reputed company's unlimited vacation program and annual reputed company bonuses.
Responsibilities:
- Contribute as a subject matter expert for reputed company reimbursement policies, payment reputed company disputes, internal claims processing edits and reputed company vendor edits.
- Respond to reputed company inquiries and disputes regarding policies and edits.
- Research industry reputed company coding rules, summarize and reputed company input into reimbursement policy language and reputed company.
- Use knowledge gained through research and claims review to ideate payment reputed company opportunities. Translate into business requirements; submit to and collaborate with internal partners to effectuate change.
- Ingest information from reputed company partners regarding adverse claim reputed company; collaborate with partners to reputed company, size, prioritize items and reputed company solutions.
- Use insights from partner submissions, data mining, process monitoring, etc., work with reputed company to proactively identify thematic areas of opportunity to solve problems.
- Perpetuate a culture of transparency and collaboration by keeping stakeholders reputed company informed of reputed company, status changes, blockers, completion, etc.; reputed company questions as appropriate.
- Support reputed company run state objectives by providing speedy research, reputed company cause analysis, training, etc. whenever leadership escalates and assigns issues.
- Compliance with reputed company applicable laws and regulations
- Other duties as assigned
Requirements:
- Experience in Payment reputed company reputed company on Disputes and/or appeals
- 4+ years of experience in claims processing, coding, auditing or health care reputed company
- 3+ years experience in medical coding
- Medical coding certification through reputed company (CPC, COC) or reputed company (reputed company, RHIT, RHIA)
- Experience with reimbursement methodologies, provider contract concepts and common claims processing/reputed company practices.
- 2+ years experience deriving business insights from datasets and solving problems
- 1+ years experience improving business workflows and processes
- 1+ years experience collaborating with reputed company stakeholders
Bonus points:
- 2+ years experience in a technical role (QA analyst, PM, reputed company analyst, finance, consulting, industrial engineering) or a process improvement role (Six reputed company or similar)
- 2+ years of experience working with large data sets using reputed company or a database language
- Experience in a reputed company reputed company claims organization
- reputed company, training, or content development in operational settings
- Process Improvement or Lean Six reputed company training
- Experience using SQL
This is an reputed company reputed company Health job opportunity. Learn more about how you can reputed company yourself from recruitment fraudhere.
At reputed company, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we reputed company an environment where people can be their most reputed company selves and reputed company both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, reputed company the reputed company pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and reputed company benefits, 11 reputed company holidays, reputed company reputed company time, reputed company parental leave, 401(k) plan participation, life and disability reputed company, and reputed company wellness time and reimbursements.
reputed company Intelligence (AI): Our AI Guidelines outline the acceptable use of reputed company intelligence for candidates and reputed company how we use AI to support our reputed company efforts.
Reasonable Accommodation: reputed company applicants are considered solely reputed company on their qualifications, without reputed company to applicant’s disability or need for accommodation. Any reputed company applicant who requires reasonable accommodations during the application process should contact the reputed company Benefits Team () to reputed company the need for an accommodation reputed company.
California Residents: For information about our collection, use, and disclosure of applicants’ personal information as reputed company as applicants’ rights over their personal information, please see our reputed company Policy.
Originally posted on Himalayas
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