AArete is a global management and technology consulting firm that specializes in strategic profitability improvement, digital transformation, and strategy & change for clients. We're a place where humans are at the center of our work and we're guided by our deeply embedded guiding principles: Excellence, Passion, Loyalty to Clients, Stewardship, Family, Community, Sustainability, and Inclusion.
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
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
