Reimbursement Review Services Analyst II (Pennsylvania Territory, partial remote)
Conduent
2024-04-29T00:00:00Z
Pittsburgh
Pennsylvania
United States
None
(No Timezone Provided)
About Conduent:
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments creating exceptional outcomes for our clients and the millions of people who count on them. You have anopportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
Job Description:
- Audits medical bills for unrelated charges, and assesses payments against either regulatory or administrative charges, coding, and billing errors to determine if fraud or inaccurate billing has occurred.
- Assists in the development and implementation of new audit/review methodologies for identifying healthcare overpayments and underpayments to providers, and the detection of healthcare fraud, waste, and abuse.
- Prepares written case summaries and represents clients and Conduent as an expert witness as required.
- Applies knowledge of provider billing and patient accounting practices to research of client policy and data to reveal new overpayment recovery opportunities.
- Develops, maintains, and ensures adherence to multiple project schedules.
- Achieves percent of savings expectations through their review billing
- Ensures productivity goals are met daily, e.g. number of bills reviewed.
- Communicates audit findings to Conduent clients.
Requirements:
- Must have strong analytical and communications skills and be able to build positive client relationships with all levels of patient accounting at hospitals
- Healthcare related insurance billing and/or claims experience is preferred.
- This job is also primarily remote (work from home), but may require up to 25% "driving" travel to client locations in the State of Pennsylvania. (So, candidates need to live in the Pennsylvania area.)
- Covid-19 Vaccination is required for this position.
Closing:
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduents ADAAA Accommodation Policy.
At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.
Associated topics: home based job, home based online, home office work, online research survey, online work, stay at home employee, stay at home online, telecommute employee, work at home contracting, work from home contracting
Reimbursement Review Services Analyst II (Pennsylvania Territory, partial remote)
About Conduent:
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments creating exceptional outcomes for our clients and the millions of people who count on them. You have anopportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
Job Description:
- Audits medical bills for unrelated charges, and assesses payments against either regulatory or administrative charges, coding, and billing errors to determine if fraud or inaccurate billing has occurred.
- Assists in the development and implementation of new audit/review methodologies for identifying healthcare overpayments and underpayments to providers, and the detection of healthcare fraud, waste, and abuse.
- Prepares written case summaries and represents clients and Conduent as an expert witness as required.
- Applies knowledge of provider billing and patient accounting practices to research of client policy and data to reveal new overpayment recovery opportunities.
- Develops, maintains, and ensures adherence to multiple project schedules.
- Achieves percent of savings expectations through their review billing
- Ensures productivity goals are met daily, e.g. number of bills reviewed.
- Communicates audit findings to Conduent clients.
Requirements:
- Must have strong analytical and communications skills and be able to build positive client relationships with all levels of patient accounting at hospitals
- Healthcare related insurance billing and/or claims experience is preferred.
- This job is also primarily remote (work from home), but may require up to 25% "driving" travel to client locations in the State of Pennsylvania. (So, candidates need to live in the Pennsylvania area.)
- Covid-19 Vaccination is required for this position.
Closing:
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduents ADAAA Accommodation Policy.
At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.
Associated topics: home based job, home based online, home office work, online research survey, online work, stay at home employee, stay at home online, telecommute employee, work at home contracting, work from home contracting