Job summary
Job post source
This job is directly from Claritev
Job overview
The Payment Integrity Coordination of Benefits Medical Investigator at Claritev reviews medical paid claims to ensure accurate processing and identifies errant payments, contributing to healthcare cost reduction.
Responsibilities and impact
The role involves analyzing and auditing medical claims using data mining and coordination of benefits techniques, evaluating coding and pricing accuracy, collaborating across departments, ensuring HIPAA compliance, and promoting a positive team environment.
Compensation and benefits
The position offers an hourly wage of $21-25, health insurance, 401k with company match, bonus opportunities, paid time off, parental leave, tuition reimbursement, and other benefits like employee stock purchase and flexible schedules.
Experience and skills
Candidates need a high school diploma or GED with 2 years of relevant experience; medical billing and coding certification and a bachelor's degree are preferred. Skills in medical terminology, coding guidelines, healthcare regulations, and proficiency with payer systems and Microsoft Excel are required.
Career development
Claritev provides professional development and educational programs, flexible schedules, and advancement opportunities to support career growth.
Work environment and culture
The company culture is innovative, accountable, diverse, and supportive, emphasizing teamwork, critical thinking, and empowerment in a friendly work environment.
Company information
Claritev is a healthcare technology and data company focused on reducing healthcare costs through innovation and service excellence.
Job location and travel
The role requires working in a standard office environment with typical office equipment; specific location details are not provided.
Application process
Applications are accepted for at least 15 days from posting or while the job remains open; referral options are available.
Unique job features
This role is high risk due to exposure to sensitive PHI data and involves using official coding guidelines and advanced data mining techniques to identify savings in medical claims.
Company overview
Claritev appears to be a company focused on providing innovative technology solutions tailored to enhance business efficiency and digital transformation. While specific details about its operations are unclear from the search results, the company seems to operate in the IT and software development space, offering services such as process automation, advanced simulations, and data-driven insights. It may also be involved in business advisory or consulting, leveraging technology to optimize workflows and decision-making processes. Further research would be needed to confirm its exact offerings and market position.
How to land this job
Position your resume to highlight your experience with medical claims investigation, data mining, and coordination of benefits auditing, emphasizing your knowledge of HCPCS, ICD-10, and CPT coding standards.
Showcase your proficiency with medical terminology, coding guidelines, federal and state healthcare regulations, and automated claims payment systems like Facets or QNXT to align with the job requirements.
Apply through multiple channels including Claritev's corporate careers page and LinkedIn to maximize your application visibility and increase your chances of being noticed.
Connect with professionals in Claritev's payment integrity or medical claims departments on LinkedIn; use ice breakers such as commenting on Claritev’s commitment to healthcare innovation or asking about how their team approaches claims accuracy and cost savings.
Optimize your resume for ATS by incorporating keywords from the job description such as 'medical claims investigation,' 'coordination of benefits,' 'HCPCS,' 'ICD-10,' 'CPT codes,' 'data mining,' and 'payer systems' to ensure it passes automated screenings.
Utilize Jennie Johnson's Power Apply feature to automate applying through multiple platforms, tailor your resume with relevant keywords, and identify LinkedIn contacts, freeing up your time to focus on preparing for interviews and networking.
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