PAYMENT ACCURACY ADVISOR- MEDICAL CLAIMS
The Payment Accuracy Advisor (PAA) role functions to implement and maintain the ClaimsXten (CXT) Rules and Rule Logic for customers’ use. As such, the PAA is assigned customers, as part of the Services Delivery Team, to understand the customers’ claim system(s), payment policies, and integration data elements managed using CXT for total payment accuracy, to carryout actions and activities such as • Consulting, gathering, and documenting intent and technical requirements for rules and non-rule work • Triage, troubleshooting, and problem-solving for rule and non-rule issues reported during implementation and upgrade projects, Go Live, and post Go Live production support • Guiding customers thru impacts for routine CXT content and rule updates • Estimating level of effort for new or existing rule work for forecasting and/or pricing • Confirmation of milestone completions by supporting works to trigger customer invoicing • Collaborating with Sr PAA and Engagement Managers for planning and managing client works • Meeting and exceeding metrics such as utilization, time entry, forecasting, etc. As a PAA, for rule and non-rule work, he/she will: • In conjunction with his/her assigned Service Delivery Team (i.e., including any off-shore resources) ensure high quality, on-time client deliveries. • Assert confidence and reliability as a trusted adviser to drive client facing initiatives through to conclusion. • Work on issues where analysis of situations or data requires an evaluation of intangibles. • Follows and maintains compliance with current methodologies, tools, procedures and processes. And in collaboration with Service Delivery Team members and supporting departments to ensure high quality work output and customer satisfaction. Business Experience • 4 – 8 +years of experience in health care combining first hand payor and consulting experience • 2 – 5 years of medical claims experience within payor environment required. • SDLC exposure needed.
Please email resume to email@example.com
Sedona Staffing Services is an Equal Opportunity Employer