Note: The job is a remote job and is open to candidates in USA. RemHive LLC is an AI healthcare technology startup focused on improving revenue cycle operations for healthcare providers. They are seeking a senior Payment Integrity professional to assist in shaping product strategy and validating workflows as part of an ongoing consulting engagement.

Responsibilities

• Work directly with our founding team to help shape product strategy
• Validate workflows
• Provide domain expertise as we build and test new capabilities

Skills

• Payment Integrity
• Pre-Pay Review
• Medical Claims Adjudication
• Clinical Claims Review
• Claims Examination
• Coding Policy
• Provider Appeals
• Commercial Payer Operations
• Years of payment integrity experience
• Current or previous employer(s)
• Areas of expertise (pre-pay, post-pay, coding, clinical review, appeals, etc.)
• Hourly consulting rate
• Availability
• Experience at organizations such as UnitedHealthcare, Elevance/Anthem, Aetna, Cigna, Humana, Molina, BCBS plans, Optum, Cotiviti, Machinify, Zelis, Rawlings, or similar organizations

Benefits

• Flexible hourly consulting role
• Potential for a longer-term relationship

Company Overview