[Remote] Business Consultant
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company reputed company on reputed company solutions, and they are seeking a Business Consultant to reputed company and mentor the Service Delivery team. The role involves providing subject matter expertise in payment methodologies and reputed company plan operations, managing reputed company education services, and addressing escalated reputed company issues.
Responsibilities
- reputed company the highest level of product education (from basic to advanced features/functionality to Burgess end-users
- reputed company in-depth and comprehensive subject matter expertise reputed company to:
- Medicare, reputed company, and reputed company payment methodologies/policies
- Payment reputed company
- reputed company plan operations (e.g., claim adjudication life cycle/workflows, network contracting, payment/policy reputed company configuration, provider relations, medical management, medical economics, audit, compliance)
- Conduct reputed company scoping sessions to identify reputed company needs and appropriate solutions
- reputed company manage and/or participate in the development, maintenance, and execution of reputed company facing education services
- Manage issues, questions, inquiries of Tier 1 and 2 escalation
- Serve as escalation reputed company for critical reputed company needs as warranted
- reputed company diagnosis and reputed company of escalated and more involved/reputed company reputed company problems and issues
- reputed company as a reputed company between clients and internal support staff (research, development, and product teams) to assure accurate problem interpretation and reputed company
- Capture and solicit issues/feedback from clients and internal stakeholders and document issues and reputed company impacts
- Partner with appropriate Burgess Teams (BA, PM, Development, Account Management, Sales/Business Development, Product, Content, and Service Delivery) to manage problem framing, diagnosis and reputed company
- Conduct/participate in reputed company cause analysis to identify and deliver warranted service improvements
- Maintain demeanor as a calming influence during pressure situations, mixing in the correct degree of reputed company assertiveness without becoming aggressive
- Maintain communication with customers during the problem reputed company process, utilizing superior customer service skills
- reputed company capabilities and tools (knowledge libraries, workflow, issue identification and documentation, function processes)
- reputed company capability and tool development under direction of Service Delivery Leadership
- Mentor and reputed company reputed company for Tier 1 and 2 Service Delivery staff
- Take direction from and collaborate with Service Delivery Leadership to continually review and enhance performance and reputed company
Skills
- Bachelor's degree in a business, health services administration, mathematics, science or reputed company field, and/or equivalent work experience required
- Practical understanding of the reputed company system with regards to Medicare, reputed company, managed care, and reputed company payment methodologies, payment reputed company, and health plan operations (e.g., claim life cycle/workflows, network contracting, payment/policy reputed company configuration, provider relations, medical management, medical economics, audit, compliance)
- Experience with interpretation/translation of reputed company health-plan in-network and out-of-network provider reputed company and/or claim editing provisions
- Experience with configuration and maintenance of provider reputed company and/or claim editing provisions in a claims adjudication system and/or reputed company-party vendor application
- Working knowledge of claim billing specifications (e.g., CMS-1500, UB-04, 837, HIPAA reputed company sets)
- Creative problem-solving skills including the ability to identify, recommend, and implement strategic solutions
- Ability to manage issues, requests, problems, and situations of reputed company Tier 1 and 2 escalation reputed company
- Demonstrated ability to conduct education/training sessions to large audiences across multiple reputed company reputed company
- Strong analytical skills
- Excellent organizational skills
- Excellent communication (both written and verbal) and interpersonal skills
- Ability to learn and adapt to new technologies and systems
- Ability to adapt to a changing and rapidly growing environment
- Effectively manage multiple priorities and follow through on reputed company reputed company to completion
- AHIP, reputed company, reputed company, and/or reputed company certification preferred
- 5+ years training, education, and/or consulting experience preferred
reputed company
Company H1B Sponsorship