Nashville, TN

Why Wellpath:

Here at Wellpath, everything that we do is about taking care of people – our patients, our staff and our partners. We are committed to making a difference by providing hope and healing to vulnerable patients in challenging clinical environments. Our talented, compassionate team thrives in an autonomous environment, is empowered and supported by education, training and the resources to practice healthcare the way it is meant to be and strives to “Always Do The Right Thing!”

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About this role:

Performs QA audits and process improvement analysis.

What you bring to the table:

Education:

• Bachelor’s degree preferred.

Experience:

• 2-3 years of experience with Medicaid/ Private insurance billing or enrollments.
• 2-3 years of experience with analyzing data, creation of reports and converting for meaningful use for internal and external clients.
• 1-2 years of experience with payment integrity and recoupments experience.

Licenses/Certifications:

• None required.

What you will do:

• Provide support in terms of knowledge and expertise to the organization’s field staff in the areas of Medicaid enrollment and eligibility.
• Escalate issues to departmental leadership as needed.
• Communicate changes related Medicaid eligibility and enrollment requirements or organizational policy changes as directed by the departmental leadership.
• Coordinate with operations, utilization management, and claims to ensure that the organization does not incur offsite costs that should be reimbursed by Medicaid or other payers.
• Assist with developing, maintaining, and communicating Key Performance Indicators (KPI) that reflect both internal and external goals.
• Proficient in using Microsoft Office Products.
• Ability to communicate effectively.
• Ability to apply principles of critical thinking to a variety of practical and emergent situations and accurately follow standardized procedures that may call for deviations.
• Ability to apply sound judgment beyond a specific set of instructions and apply knowledge to different factual situations.
• Ability to work independently to complete tasks.
• Ability to remain alert at all times; pay close attention to details.
• Ability to work under stress on a regular or continuous basis.
• Perform other duties as assigned.

Wellpath is an EOE/Minorities/Females/Vet/Disability Employer

Our investment in you:

• Medical, Dental and Vision Insurance plan options
• Time off & leave benefits
• 401K
• Tuition Reimbursement
• Parental benefits
• Perks and discounts
• And more available here {apply below}