Payment Accuracy Advisor Jobs

Ability to work remotely and on their own schedule in order to make deadlines

Respect for and reliance on historical evidence and ability to utilize such knowledge to enhance writing projects

Conduct research to verify historical data and anecdotes used in Uncle Sam project materials, book projects and any other ONC content

Analyze and fact-check all written materials for historical accuracy

Evaluate primary sources for credibility and historical legitimacy

Use research and analysis of content to give context to scripts and book projects

Use your plan-o-gram knowledge to build displays, stock shelves, and add/remove signage.

Assist customers with their shopping needs and transactions.

Tend to merchandising tasks via plan-o-gram.

Ensure store inventory is regularly counted, inspected, removed, or rotated according to the date.

Maintain a safe, clean, organized, and pleasing environment for customers and associates.

Operate the One-Hour Photo department, if applicable.

Enter design details into content management software including data entry, downloading, and attaching source documents

Experience in an analytic role collecting, querying, reporting, analyzing, and presenting data; preference in healthcare, accounting, or corporate finance setting

Comfortability using Jira, Google Apps (Google Docs, Google Sheets), Notion, Slack, and Content management software.

Ability to quickly learn business-specific software (e.g., project management, document creation)

Work closely with a team of experts with extensive medical claims experience

Utilize strong coding and industry knowledge to research regulatory updates, create and maintain editing content (data used by the edits)

Manages the workflow within the systems to maintain timely and thorough review of documentation.

The responsibilities listed are a general overview of the position and additional duties may be assigned.

Coding Knowledge (Advanced): Ability to assign and interpret ICD-10-CM/PCS coding classification systems and MS-DRG and APR-DRG prospective payment and severity systems.

Tracks, monitors, and updates billing systems. Updates system functionality in response to changes in overall billing practices or other operational changes.

Performs analysis of charges generated from systems to verify accuracy.

Identifies deficiencies or discrepancies in provider documentation that affects billing.

Minimum 3 year’s knowledge of direct claim processing/reimbursement, medical facility contracts, fee schedules, inpatient/outpatient/physician claims or strong data analytics experience required

Utilizing healthcare experience to perform audit recovery procedures

Certified Professional / Hospital Coder Certification (CCS, CPC, CPC-H, CCS-P, CCRC, CCS-A, RHIA, RHIT ) preferred

Prior claims auditing or consulting experience desirable in either a provider or payer environment

Excellent communication skills both oral and written

Strong interpersonal skills that will support collaborative team work

Analyzing user requirements, procedures and problems to automate or improve existing systems and review software application capabilities, workflow and scheduling limitations

Experience working with IT staff in providing structured requirement documents, peer review, system testing, test case review etc.

What other skills/experience would be helpful to have?

Analyze and implement the business requirements for our application and its interface with customers’ claims processing systems

5+ years of related experience with healthcare payers

In-depth knowledge of Healthcare Claims processing, familiar with medical coding

Must be computer literate, with a background in data entry.

Work safely and address any potential safety hazards.

Organize formal counting of bins at the GWD DC, DFS, Ingredients and other site locations

Support supply chain functions as forklift driver as needed.

Lift/move cartons (up to 35 lbs).

Perform work at multiple locations on the GWD campus depending on business needs.

Analyzing user requirements, procedures and problems to automate or improve existing systems and review software application capabilities, workflow and scheduling limitations

Experience working with IT staff in providing structured requirement documents, peer review, system testing, test case review etc.

What other skills/experience would be helpful to have?

Analyze and implement the business requirements for our application and its interface with customers’ claims processing systems

5+ years of related experience with healthcare payers

In-depth knowledge of Healthcare Claims processing, familiar with medical coding

Bachelor's degree preferred OR at least 1 year of relevant experience (healthcare billing, claims, auditing, reimbursement or data analysis)

Excellent verbal and written communication skills

Solve problems by identifying errors and overpayments for our healthcare clients

Use your creativity to help generate new ideas for claim concepts and recovery opportunities

Learn and use multiple computer software, systems and technology

Achieve excellence by meeting and exceeding audit team goals and quality measures

Healthcare industry experience, including knowledge of Coordination of Benefits. (Preferred).

Utilizes Cotiviti audit tools (Recovery Management System (RMS), COB Tracker, specific client systems)

Demonstrates understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements.

Bachelor’s degree (Preferred) and/or a minimum of at least one (1) year related experience in healthcare.

At least 1-year Cotiviti experience is recommended for individuals seeking their next opportunity internally.

Excellent verbal and written communication skills.

Analyzing user requirements, procedures and problems to automate or improve existing systems and review software application capabilities, workflow and scheduling limitations

Experience working with IT staff in providing structured requirement documents, peer review, system testing, test case review etc.

What other skills/experience would be helpful to have?

Analyze and implement the business requirements for our application and its interface with customers’ claims processing systems

5+ years of related experience with healthcare payers

In-depth knowledge of Healthcare Claims processing, familiar with medical coding

Minimum 3 year’s knowledge of direct claim processing/reimbursement, medical facility contracts, fee schedules, inpatient/outpatient/physician claims or strong data analytics experience required

Utilizing healthcare experience to perform audit recovery procedures

Certified Professional / Hospital Coder Certification (CCS, CPC, CPC-H, CCS-P, CCRC, CCS-A, RHIA, RHIT ) preferred

Prior claims auditing or consulting experience desirable in either a provider or payer environment

Excellent communication skills both oral and written

Strong interpersonal skills that will support collaborative team work

* Consulting, gathering, and documenting intent and technical requirements for rules and non-rule work

* Collaborating with Sr PAA and Engagement Managers for planning and managing client works

- 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