Eligibility Analyst

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $85 - $90 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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Chartis

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💼 Consulting

💰 Private Equity Round on 2012-12

Healthcare • Healthcare Insurance • Consulting

Chartis is a healthcare management consulting firm focused on transforming the US healthcare system. The company offers a wide range of services including strategic transformation, financial transformation, digital and technology transformation, and clinical transformation. Chartis specializes in helping providers, payers, and investors navigate the complexities of healthcare, with a strong emphasis on health equity, strategic communications, and mergers and integration. They are recognized as the Best Overall Management Consulting Firm by KLAS and work with a diverse clientele including academic medical centers and health systems across the United States. Their mission is to improve the delivery of healthcare by providing innovative solutions tailored to the unique challenges faced by their clients.

📋 Description

• Assess current real-time eligibility configuration, errors, workflows, active tickets, and high-volume payers • Develop a prioritized roadmap based on volume, impact, urgency, and patient experience • Review payer/plan structure, plan mapping, unique plan mapping, synonyms, and ongoing maintenance • Assess generic coverage utilization and address payer/plan configuration, workflow, and education gaps • Review HB and PB priority payers by 271 section, plan mapping, and benefit filing behavior • Review deductibles, copays, Tier 1/Tier 2 benefits, service type mapping, and estimate accuracy issues • Optimize RTE coverage auto-creation and Medicare replacement chaining • Review coverage changes, filing order, COB, and payer selection workflows • Partner with Patient Access on payer selection guidance, registration education, job aids, and standard workflows • Establish monitoring, documentation, ownership, and knowledge transfer for internal team sustainment

🎯 Requirements

• Must be RTE Certified • Must have been in active RTE type roles • Cadence or Prelude certification is a plus • Tapestry integration experience is a plus, but not required • Legally authorized to work in the United States

🏖️ Benefits

• Remote work is allowed • Equal opportunity employment • Diverse workforce and inclusive workplace

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