Claims Validation Consultant - Atlanta - Rialtic

    Rialtic
    Rialtic Atlanta

    1 day ago

    Description

    Rialtic's Claims Validation Consultant role involves researching and interpreting healthcare policies to prevent overpayments. You'll develop claims editing logics that promote payment accuracy and transparency across Medicaid, Medicare, and commercial lines of business.

    • Review healthcare policy manuals, fee schedules, CCI alerts, LCAs/LCDs NCDs
    • Work with concept creation team on billing edits providing clients monetary savings promoting coding accuracy
    • Evaluate structural design following policy intent using data analysis

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