Payment Intelligence Consultant

Join AArete as a Payment Intelligence Consultant! At AArete, we pride ourselves on cultivating a unique consulting firm culture. As a global leader in management and technology consulting, with offices across the U.S., India, and the U.K., we embody the Greek word for excellence: "Arete." Our commitment to excellence is evident in everything we do. We believe our success stems from empowering our employees. With comprehensive career development plans and competitive benefits, AArete’s "Culture of Care" fosters a holistic employee experience. The Opportunity As health plans continue to struggle with timely and accurate claims reimbursements, AArete’s Payment Intelligence service line goes beyond conventional payment integrity. We identify and rectify erroneous payments and prevent future issues. You will address critical areas such as payment policies, provider contracts, and member eligibility. In this exciting role, you will be the go-to expert on strategies that ensure accurate claims payment through (1) claims analytics, (2) process enhancements, (3) integration of technology, and (4) configuration setups. You will work under the guidance of a Payment Intelligence Manager and contribute to internal initiatives. Your Responsibilities Assist in identifying and analyzing payment accuracy opportunities alongside client teams. Utilize analytics to uncover claims payment opportunities based on standard methodologies like IPPS/OPPS, fee-for-service, and various payment models. Drive process improvements and automation initiatives for client operations. Conduct research on regulatory changes and market trends impacting health plan reimbursements. Prepare client-ready deliverables with clear, actionable insights. Demonstrate sound judgment and clear communication in all tasks. Undertake additional duties as needed. Qualifications 2+ years of experience in consulting, provider revenue cycle, payment integrity, or payer organizations. Foundational understanding of claims processing across multiple healthcare lines, including Medicare and Commercial. Experience in a variety of spend areas including professional and inpatient services. Skills in identifying and analyzing mispaid claims ensuring accuracy and compliance. Familiarity with industry vendors and tools for claims processing and provider data management. Comprehensive understanding of end-to-end claims processes. Strong verbal and written communication skills, with experience presenting to diverse audiences. Experience coaching and mentoring peers. Proficiency in Microsoft Excel and basic to intermediate SQL for data analysis. Exceptional analytical and problem-solving abilities. Able to identify savings opportunities for clients and develop actionable business cases. Bachelor's degree or equivalent experience required. Client interaction may require travel to various locations. Must be authorized to work in the U.S. without sponsorship. Preferred Skills Policy & Claims Editing Expertise: Familiar with healthcare policies, claims editing processes, and reimbursement policy writing. Contract Configuration & Provider Data Expertise: Experience interpreting provider contracts, pricing methodologies, and understanding network processes. Familiar with claims adjudication systems (e.g., Facets, QNXT, Amisys, etc.). Ability to work from our office based in Chicago, IL as needed. Compensation & Benefits Flexible paid time off, including volunteer days and holidays. Own Your Day flexible work policy. Comprehensive benefits including medical, dental, vision, and 401K matching. Generous paid parental leave. Employer-funded life insurance and short- and long-term disability. Programs for charitable giving and client referral bonuses. Discount programs for bike sharing. The estimated base salary range for this position is $84,000 - $102,000, along with potential bonuses. Please note this is a guide, and compensation may vary based on experience and qualifications. We prioritize making human impact at AArete. Our reputation as a top consulting firm is reflected in recognitions from Forbes, Consulting Magazine, and more. We are dedicated to our principles of excellence, community, and inclusion. We are an equal opportunity employer and welcome all qualified applicants. We look forward to your application!

Created: 2026-03-04