Healthcare Post Pay Consultant

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

Jun 17, 2025 - 23:20

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