- We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
- Join the team and we will invest in your future
- Accrued PTO starting day one, plus additional days off when you're not feeling well, to observe holidays.
- We care about your wellbeing. From Commuter Benefits to FSAs we've got you covered.
- Through continued education/mentorship on the job and our investment in LinkedIn Learning, we're focused on your growth as a working professional.
-
Pricing Specialist
1 week ago
Consultative Search Group New York, United StatesNew Pricing Analyst Role Available · NYC, Wash DC, Houston, Dallas, Denver, LA, SF and Silicon Valley, Orange County · Remote with Flexibility(must be flexible to come to office every now and then & must live in a commutable range to one of the following cities) · If you are look ...
-
Rates & Pricing Specialist
3 weeks ago
Taylor Root New York, United StatesWork for a top law firm on a small team and work hands on with clients and Senior Leaders at the firm. · Responsibilities · Ensure Alternative Fee Arrangements (AFAs) are set up · Handle rate reviews and audits · Create and maintain rate cards · Update annual renewal rates wit ...
-
Pricing Analyst Specialist
1 week ago
Fidelity Information Services New York, United StatesJOB DESCRIPTION · Position Type : · Full time · Type Of Hire : · Experienced (relevant combo of work and education) · Education Desired : · Bachelor of Accounting · Travel Percentage : · 5 - 10% · Job Description · Are you curious, motivated, and forward-thinking? At FI ...
-
Rates & Pricing Specialist
3 weeks ago
Taylor Root New York, United StatesWork for a top law firm on a small team and work hands on with clients and Senior Leaders at the firm. · Responsibilities · Ensure Alternative Fee Arrangements (AFAs) are set up · Handle rate reviews and audits · Create and maintain rate cards · Update annual renewal rates w ...
-
Real-time Pricing Specialist
1 week ago
Bloomberg New York, United StatesReal-time Pricing Specialist · **New York, NY** · Posted Mar 1, Requisition No · We are Bloomberg Enterprise Data - fast paced, innovative and expanding We partner closely with our clients, taking time to understand their unique businesses and individual data and financial tec ...
-
ETF Pricing Engineering Specialist
1 week ago
Hudson River Trading New York, United States Full timeHudson River Trading (HRT) is seeking an ETF Pricing Engineering Specialist to join our high-impact team working on the firm's growing ETF efforts. In this role, you'll collaborate with global trading teams, interface with automated trading systems across asset classes and region ...
-
Pricing Tool Specialist
2 weeks ago
Munich Re New York, United States Full timePricing Tool Specialist Company Munich Re America Location New York , United States · Pricing Tool Specialist · We will consider candidates in New York NY, Philadelphia PA, Princeton NJ or Hartford CT · We are adding to our diverse team of experts and are looking to hire thos ...
-
Area Air Logistics Pricing Specialist
4 days ago
Kuehne+Nagel Jersey City, United States Full time, PermanentJOB DESCRIPTION Would you like to launch your career with one of the most successful logistics organizations worldwide? Here at Kuehne+Nagel, our Jersey City site is looking for a new Area Air Logistics Pricing Specialist to join our Air Logistics team. Your Role · As part of ...
-
MedReview Inc. New York, United StatesPosition Summary · At MedReview, our mission is to bring accuracy, accountability and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. · Pricing and analysis of i ...
-
ETF Pricing Engineering Specialist
2 weeks ago
Hudson River Trading New York, United StatesHudson River Trading (HRT) is seeking an ETF Pricing Engineering Specialist to join our high-impact team working on the firm's growing ETF efforts. In this role, you'll collaborate with global trading teams, interface with automated trading systems across asset classes and region ...
-
ETF Pricing Engineering Specialist
2 weeks ago
Hudson River Trading New York, United StatesHudson River Trading (HRT) is seeking an ETF Pricing Engineering Specialist to join our high-impact team working on the firm's growing ETF efforts. In this role, you'll collaborate with global trading teams, interface with automated trading systems across asset classes and region ...
-
Area Air Logistics Pricing Specialist
1 week ago
Kuehne + Nagel Jersey City, United StatesArea Air Logistics Pricing Specialist |United States | US2065700 · Would you like to launch your career with one of the most successful logistics organizations worldwide? Here at Kuehne+Nagel, our Jersey City site is looking for a new Area Air Logistics Pricing Specialist to joi ...
-
Price Scanning Specialist
5 days ago
RetailData Bergenfield, United StatesRetail Data, LLC · Price Scanning Specialist · Bergenfield , · New Jersey · Apply Now · Are you tired of being unsure how much your delivery/driver job will pay? Will the customer tip? We have a great side hustle job for you Our jobs are preplanned with a flexible schedule, ...
-
Area Air Logistics Pricing Specialist
1 week ago
Kuehne Nagel Jersey City, United States OTHERWould you like to launch your career with one of the most successful logistics organizations worldwide? Here at Kuehne+Nagel, our Jersey City site is looking for a new Area Air Logistics Pricing Specialist to join our Air Logistics team. Your Role · As part of your role, you met ...
-
ALM Risk Model Validation Associate/VP
2 weeks ago
Selby Jennings New York City, United States Full timeA leading international financial institution is expanding its team and seeking a Risk Model Validation Specialist with a strong quantitative background to join the Market & Liquidity Model Validation Team within the Model Risk & Validation Group. This team is responsible for the ...
-
Pricing Ops Analyst
6 days ago
Jobs for Humanity New York, United States Full timeJob Description · Position Type : · Full time Type Of Hire : · Experienced (relevant combo of work and education) Education Desired : · Bachelor of Accounting Travel Percentage : · 5 - 10%Job Description · The world of finance moves fast. At FIS, we're faster. Our teams are e ...
-
Capital Procurement Specialist
2 weeks ago
Insight Global New York, United StatesTitle: Capital Procurement Specialist · Location: Park Ave New York, NY – 2x week onsite Wed/Thurs · Duration: 6 months + extensions, possible conversion · Must-Haves: · 3+ years of sourcing experience in an enterprise environment · Experience negotiating pricing associated with ...
-
Construction Estimator
2 weeks ago
Northeast Remsco Construction New Jersey, United StatesHeavy Civil Construction ESTIMATOR · Join Northeast Remsco Construction as trenchless and heavy civil construction specialists we are dedicated to constructing reliable and sustainable infrastructure. · The Estimator will be responsible for the pricing of activities assigned by ...
-
Senior Director, Private Sales
3 days ago
Level & Co. New York, United StatesPosition Overview: · Level & Co. is a secondary market gallery specializing in Post-War and Contemporary art from abstract expressionism to neo-expressionism to 21st-century masters. As a Masterworks affiliate, we act as the primary sourcing agent to find collectors interested in ...
-
All-Inclusive Resort Specialist
4 weeks ago
Sky Land and Ocean travel New York, United StatesThis is a remote position. · Remote All-Inclusive Resort Specialist - Turn Your Love for Travel into a Rewarding Career · About Us: Join our team of Remote All-Inclusive Resort Specialists and embark on an exciting career that combines your passion for travel with your expertise ...
Team Lead, Inpatient Claims Pricing Specialist - New York, United States - Med Review Inc
![Default job background](https://contents.bebee.com/public/img/bg-user-ex-1.jpg)
Description
Position SummaryAt MedReview, our mission is to bring accuracy, accountability and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews.
Pricing and analysis of inpatient medical claims utilizing NYCHSRO/MedReview and payer specific systems, adjudication platforms, policies, and procedures.
Provide support to various departments related to claim status, claim adjudication questions, and any basic questions related to the adjudication of an inpatient medical claim.
Candidate should be highly motivated, with strong pricing background including experience in platforms such as Facets, Webstrat, and Encoder.This individual must have excellent communication skills, must be analytical, have strong problem solving skills, and have the ability to make quality decisions.
This is a fulltime position (40 hours per week) Monday – Friday. You'll enjoy the flexibility to telecommute from anywhere within the United States. Training will be conducted virtually from your home.Responsibilities:
This list does not represent all responsibilities for this position.
Candidate must understand and be willing and able to assume roles and responsibilities other than these to meet the needs of MedReview Operations in general.
Serves as a knowledge expert and maintains up to date working knowledge of pricing guidelines in order to act as a resource for all pricing team members.
Responsible for reviewing data in the review application and client claim processing system, and comparing with corresponding UB, medical record or other documentation.
Responsible for reviewing all necessary documentation as necessary to determine appropriate reimbursement for a claim.Responsible for reviewing adjudication software system's claim and line items for determination of how to price a claim / line item.
Possess ability to work at a computer for extended periods.Performs quality reviews on individual team members ensuring all claims are completed timely and per department standards.
Identifies education needs within the department to facilitate pricing accuracy improvement.
Works collaboratively with Assistant Director of Pricing to analyze and optimize processes to maintain acceptable productivity rates for each individual team member.
Works collaboratively with Assistant Director in developing educational tools for new hire orientation and ongoing department education.Other duties as assigned.
Qualifications:
Associates degree preferred.
Minimum of 5 years management experience
Minimum of 5 years related work experience. Prior experience with claim adjudication systems, grouping and pricing software, and other claim adjudication and claim pricing systems. Ie; Facets, Cosmos, CAS, WebStrat, Encoder.
Experience with pricing reject resolution
Basic knowledge of medical terminology.
Good knowledge of Microsoft Word, Excel and Outlook
Intermediate mathematics aptitude
Good communication skills
Good organizational abilities
Good comprehension capabilities
Ability to prioritize multiple tasks
Experience with UB/institutional claims
Knowledge of Medicare and Medicaid billing & payment and coverage guidelines
Strong experience in the analysis and processing of claims, quality assurance, CMS payment methodologies (i.e., DRGs, Cost Outliers)
Must be able to work with minimal supervision
Creative thinker with good skills at problem resolution specifically related to healthcare claim adjudication
High speed internet (300 Mbps per person recommended) with secured WIFI.
Benefits and perks include:
Healthcare that fits your needs
#J-18808-Ljbffr