Claims Business Analyst - Payment Accuracy Advisor

Post Date

Feb 16, 2024

Location

King Of Prussia,
Pennsylvania

ZIP/Postal Code

19406
US
Jun 22, 2024 Insight Global

Job Type

Contract

Category

Business Analyst (BA)

Req #

KPD-683491

Pay Rate

$42 - $62 (hourly estimate)

Job Description

Our client is a Healthcare Software company that provides revenue and payment cycle management and connects payers, providers, and patients to the healthcare system.



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.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.

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Required Skills & Experience

- 4-8 years of experience working as a claims BA or payment accuracy advisor

- Prior experience working for Healthcare Insurance companies

- Healthcare Claims experience (claims processing, payment and adjudication)

- Prior experience working with ClaimsXten (CXT)

- Strong communication, client facing and analytical skills

- Medical Coding background

- strong understanding on SDLC

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.