Healthcare Post Pay Consultant

Job Summary

A company is looking for a Healthcare Post Pay Solutions Consultant.

Key Responsibilities

• Oversee COB and/or Data Mining initiatives to drive operational excellence
• Analyze claim inventory from identification to resolution and collaborate on client-specific business rules
• Develop and execute audits to identify claims not paid according to payment policies

Required Qualifications

• 5+ years of experience in healthcare, including health insurance and claims processing
• 5+ years auditing medical claims as a Payment Integrity Vendor or within a Health Plan's Payment Integrity team
• 5+ years performing data analytics with large data sets
• Working knowledge of medical billing codes and understanding of medical terminology
• Knowledge of Managed Care, Medicare, or Medicaid