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Claims Specialist 2

Company: Public Consulting Group
Location: Carson City
Posted on: August 7, 2022

Job Description:

**Overview****About Public Consulting Group** Public Consulting Group, Inc. (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,500 professionals in more than 60 offices worldwide-all committed to delivering solutions that change lives for the better. The firm has four designated practice areas with extensive experience in all 50 states, clients in six Canadian provinces, and a growing practice in Europe. Often combining resources from two or more practice areas, PCG offers clients a multidisciplinary approach to solve their challenges or pursue opportunities. To learn more, visit www.publicconsultinggroup.com .**Responsibilities**Overall Responsibilities:Claims Analysts work in a deadline-oriented, fast paced environment as part of a growing and transitioning team. The team goal is to provide superior service to school districts and state departments in the area of school-based Medicaid claiming. Claims Analysts have familiarity with billing healthcare claims and can quickly learn PCG's web-based technologies. Claims Analysts focus on each step of the claiming cycle, with a particular focus on quality control in the claiming process and an unwavering commitment to compliance. Claims Analysts are responsible for analyzing, auditing, and investigating their assigned projects/clients' claiming process to ensure quality, resolve matters, and provide strategic solutions.Specific Responsibilities:+ Monitor and manage claiming cycle in assigned states/projects including running data reports, generating claims within PCG's proprietary billing system, completing quality assurance checks, downloading and submitting files to state system(s), and retrieving responses once files have been processed+ Responsible for closely monitoring timelines and task completion and immediately escalating any challenges impacting timelines+ Serve as the main point of contact for claiming inquires related to assigned states/projects and collaborate across internal teams to identify resolutions to any challenges+ Review and troubleshoot inquires related to healthcare claims through review of supporting documentation, remittance advices, and Medicaid eligibility files for PCG clients+ Perform detailed analysis on claims and payment information including annual trends and month over month variations+ Responsible for closely monitoring and managing changes in any claiming parameters and routinely updating documentation of project/state specific processes and procedures+ Collaborate across teams to identify and provide solutions when errors arise and address and respond to triage requests from assigned projects/clients+ Provide ad-hoc support to create and analyze complex documentation reports for internal and external stakeholders+ On an ad-hoc basis may be assigned special tasks including audit response preparation, special analysis of reimbursement optimization, and support testing of newly released development features.**Qualifications**Required Skills:+ Demonstrated time management and organizational skills, ability to manage multiple deadlines and projects+ Demonstrated excellence in technological roles, ability to quickly understand and adopt new technologies+ Ability to evaluate, prioritize, and perform operational and analytical tasks+ Ability to build and maintain working relationships with internal contacts+ Strong Microsoft application skills including Word, Excel, and Microsoft Outlook+ Prior experience with a task management system a plus (e.g., Asana or Jira)+ Excellent organizational and communication skills+ Ability to work both in a team environment and autonomouslyRequired Experience:+ High School Diploma or equivalent is required. A Bachelor's Degree is preferred+ At least 2-3 years of data analytics/data processing work experience+ Healthcare claiming experience a plus+ School district (K-12) knowledge a plus+ Quality control auditing and analysis experience a plus\#LI-Remote\#LI-DL1**EEO Statement**Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employmentregarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programsare based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.\> **Job Locations** _US_**Posted Date** _2 weeks ago_ _(7/22/2022 9:31 AM)_**_Job ID_** _2022-8358_**_\# of Openings_** _1_**_Category_** _Customer Service/Support_**_Type_** _Regular Full-Time_**_Practice Area_** _Education Services_Public Consulting Group is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, protected veteran status, or status as a qualified individual with a disability. VEVRAA Federal Contractor.

Keywords: Public Consulting Group, Reno , Claims Specialist 2, Other , Carson City, Nevada

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