Payment Accuracy and Concept Lead – AI-Driven

🕒 March 31

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Team8

51 - 200 employees

Founded 2014

🏢 Enterprise

🔒 Cybersecurity

💳 Fintech

Enterprise • Cybersecurity • Fintech

Team8 is a company builder and venture group that partners with entrepreneurs to co-found companies in enterprise technology, cybersecurity, artificial intelligence, fintech, and digital health industries. They focus on providing an unfair advantage to startups by integrating expertise, resources, and a community of C-level executives known as the 'Village'. Team8 emphasizes building innovative companies that address significant challenges and opportunities, with a model that involves leading investments in early-stage rounds and collaborating closely with enterprises to facilitate digital transformation.

📋 Description

• Discover medical billing errors and fraudulent billing patterns of medical claims • Utilize Bluespine platform to develop and enhance new audit concepts using healthcare. • Lead concept creation across multiple audit verticals • Collaborate with R&D for testing • Work closely with Medical Coders, Data Sciences, and Engineering teams to ensure alignment and drive impactful results • Lead in-depth research of new ideas and concepts

🎯 Requirements

• Extensive knowledge of medical terminology • medical records • health information management • medical coding • DRG methodologies • CPT/HCPCS coding guidelines • physician specialty guidelines • reimbursement programs • claims adjudication processes • member contract benefits • provider billing systems and practices. • Previous auditing or consulting experience in a provider or payer environment is preferred • Registered Nurse required; Bachelor's or Graduate degree • Previous auditing or consulting experience with self-insured companies

🏖️ Benefits

• health-IT domain • cutting-edge technologies • personalized precision • new audit concepts using healthcare

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