Associate Consultant, Zero Balance

Job Description: • Manage client projects and relationships by participating in meetings, managing action items through to completion, answering client questions, and independently writing client emails • Compile, QA, and independently manage client processes from start to finish, such as provider relation escalations, bulk issues, regular reports, and invoices • Manage internal staffing and project needs, including answering questions from other team members on assigned client and monitoring project profitability • Research and determine next steps for complex and new payer issues and reimbursement areas to uncover potential opportunities, such as reimbursement guidelines and healthcare legislation • Create and update project plans, including outlining potential risk areas of a hospital-payer contract based on reimbursement structure and how to manually identify within the data • Review and summarize pricing documents based on hospital contracts to calculate expected payments, including Medicaid, percentage of charge, per diems, Medicare IPPS, MSDRG, outlier and/or stoploss, implants, drugs, and other reimbursement models • Make thorough client observations and recommendations after completing a project audit regarding underpayment exposure, contract risk, and other potential issues • Work with other account executives and managers to effectively submit bulk listings of accounts to insurance companies for reprocessing (e.g. rebill) • Escalate accounts to insurance provider relations for resolution and payment, including corresponding appropriately with provider relations teams, tracking progress of issues and ensuring that deadlines are met • Examine feedback from other internal teams on project activity and provide teams appropriate direction regarding account action when auditing and/or pursuing payments • Contribute meeting content to team meetings, AC biweekly meetings, and internal project related meetings • Help create and implement process improvements and trainings to protect future revenue • Understands and implements best practices for internal processes, communication, and documentation Requirements: • A minimum of 3 years of experience in areas of research and analysis • A minimum of 3 years of verifiable work history • A minimum of 3 years of experience with managed care contracts and hospital reimbursement • A minimum of 2 years of experience working with clients or equivalent • Must have achieved High School Diploma or GED • 3 years of experience working in MS Office, with emphasis on advanced Excels skills, requiring experience with formulas, graphing, and reports to manipulate pricing tools and edit project reports • Demonstrated problem solving and critical thinking skills • Demonstrated ability to meet project deadlines • Demonstrated excellent written and verbal communication skills, to include writing professional documents and delivering presentations. • Diligent and strong attention to detail Benefits: • Health insurance • Professional development opportunities • Flexible work arrangements Apply tot his job Apply To this Job