Our client is a Healthcare Software company that provides revenue and payment cycle management and connects payers, providers, and patients to the healthcare system. They are looking to hire a Payment Accuracy Advisor for an 18-month remote contract to hire opportunity.
The Payment Accuracy Advisor (PAA) role functions to implement and maintain the ClaimsXten (CXT) Rules and Rule Logic for customers' use. As such, the PAA is assigned customers, as part of the Services Delivery Team, to understand the customers' claim system(s), payment policies, and integration data elements managed using CXT for total payment accuracy, to carry out actions and activities such as:
* Consulting, gathering, and documenting intent and technical requirements for rules and non-rule work
* Triage, troubleshooting, and problem-solving for rule and non-rule issues reported during implementation and upgrade projects, Go Live, and post Go Live production support
* Guiding customers thru impacts for routine CXT content and rule updates
* Estimating level of effort for new or existing rule work for forecasting and/or pricing
* Confirmation of milestone completions by supporting works to trigger customer invoicing
* Collaborating with Sr PAA and Engagement Managers for planning and managing client works
* Meeting and exceeding metrics such as utilization, time entry, forecasting, etc.
As a PAA, for rule and non-rule work, he/she will:
* In conjunction with his/her assigned Service Delivery Team (i.e., including any off-shore resources) ensure high-quality, on-time client deliveries.
* Assert confidence and reliability as a trusted adviser to drive client-facing initiatives through to conclusion.
* Work on issues where analysis of situations or data requires an evaluation of intangibles.
- Prior experience working for Healthcare Insurance companies
- Healthcare Claims experience (claims processing, payment and adjudication)
- Prior experience working with ClaimsXten
- Strong communication, client facing and analytical skills
- Medical Coding background
- Experience working for BCBS