Solution Specialist, Payment Intelligence

AArete is a global management and technology consulting firm with a culture of excellence, innovation, and care. We are seeking a Solution Specialist, Payment Intelligence to join our team in Chicago, IL. As a Solution Specialist, you will be responsible for delivering claims analytics and post-pay data mining edits for client engagements. You will be the subject matter expert on strategies to help our clients ensure proper claims payment through the use of claims analytics, process improvements, integration of automation/technology, and configurations setups.

Requirements

• 2+ years of experience in payment integrity, healthcare analytics, or payer operations
• Foundational knowledge of claims processing across multiple lines of business, including Medicare, Medicaid, ACA/Marketplace, Commercial, and Duals
• Experience across various spend areas (professional, ancillary, outpatient, and inpatient), familiarity with modifiers, place of service codes, and NPI/TIN relationships
• Ability to identify incorrect claims payments
• Knowledge of industry vendors and tools related to claims processing, provider data, and contract management
• Understanding of end-to-end claims processes, including claims management, provider lifecycle, and network optimization
• Strong professional communication skills, including written, verbal, interpersonal, and in-person presentation expertise
• Advanced proficiency utilizing Microsoft Excel
• Strong analytical, data interpretation, and problem-solving skills
• Ability to identify client savings opportunities and develop actionable business cases
• Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules
• Bachelor’s Degree or additional years of experience in lieu of degree
• Must be legally authorized to work in the United States without the need for employer sponsorship

Benefits

• Flexible PTO
• monthly half-day refuels
• volunteer time off
• 10 paid holidays
• Own Your Day flexible work policy
• Competitive majority employer-paid benefits: Medical, Dental, Vision, 401K Match
• Generous paid parental leave options
• Employer paid Life Insurance, STD, LTD
• Charitable contribution matching program
• New client commission opportunities and referral bonus program
• Bike share discount program