Real Time Eligibility Healthcare Analyst

Chartis; United States; Remote; USD 117,000 - 124,000; Full time

Benefits offered by this job

Remote work

Job summary

Chartis is seeking a Real Time Eligibility Analyst on a 3-6 month contract in the United States. Ideal candidates are RTE certified and have active RTE experience. Cadence or Prelude certification is a plus.

The role involves assessing configuration, workflows, tickets, and high-volume payers; mapping payer/plan structures; optimizing coverage creation and COB workflows; and partnering with Patient Access for education and job aids. Remote work is allowed.

Qualifications

• RTE certification and active RTE experience required.
• Cadence or Prelude certification a plus.

Responsibilities

• Assess current configuration, errors, workflows, active tickets, and high-volume payers.
• Develop a prioritized roadmap based on volume, impact, urgency, and patient experience.
• Review payer/plan structure, plan mapping, synonyms, and ongoing maintenance.
• Address why staff select generic coverages and fix underlying configuration/education gaps.
• Review HB and PB priority payers by 271 section and benefit filing behavior.
• Review deductibles, copays, Tier 1/Tier 2 benefits, and service type mapping.

Skills

RTE Certification

Active RTE experience

Tools

Tapestry integration

Job description

About Chartis

The challenges facing US healthcare are longstanding and all too familiar. We are Chartis, and we believe in better. We work with more than 1,900 organizations annually to develop and activate transformative strategies, operating models, and organizational enterprises that make US healthcare more affordable, accessible, safe, and human. With more than 1,450 professionals, we help providers, payers, technology innovators, retail companies, and investors create and embrace solutions that tangibly and materially reshape healthcare for the better. Our family of brands—Chartis, Jarrard, Greeley, and HealthScape Advisors—is 100% focused on healthcare and each has a longstanding commitment to helping transform healthcare in big and small ways. Believe in better.

Chartis has offices in Boston, Chicago, New York, Washington D.C., and Nashville.

Remote work is allowed.

Role Overview

Real Time Eligibility Analyst (3-6 month contract)

Must be RTE Certified and been in active RTE type roles.

Cadence or Prelude certification a plus.

• RTE assessment and prioritization: Assess current configuration, errors, workflows, active tickets, and high-volume payers. Develop a prioritized roadmap based on volume, impact, urgency, and patient experience.

• Payer and plan record strategy: Review payer/plan structure, plan mapping, unique plan mapping, synonyms, and ongoing maintenance.

• Generic coverage utilization: Assess why staff are selecting generic coverages and address the underlying payer/plan configuration, workflow, and education gaps. Generic Commercial utilization has already been identified as contributing to claims routing to No Response buckets.

• Major payer review: Review HB and PB priority payers by 271 section, plan mapping, and benefit filing behavior.

• Benefit and service type mapping: Review deductibles, copays, Tier 1/Tier 2 benefits, service type mapping, and related estimate accuracy issues.

• Coverage creation and automation: Optimize RTE coverage auto-creation and Medicare replacement chaining where appropriate.

• Coverage Manager and COB: Review coverage changes, filing order, COB, and related payer selection workflows.

• Registration workflow and education: Partner with Patient Access to develop payer selection guidance, Registration education, job aids, and standard workflows that support the configuration changes.

• Sustainment: Establish monitoring, documentation, ownership, and knowledge transfer so the internal team can maintain the environment.

• Tapestry integration: Experience is a plus, but not required.

Hourly range: $85-$90. The hourly range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skills, experience, training, licensure and certifications, practice area, and other business and organizational needs. In addition.

At Chartis, we pride ourselves on having a diverse workforce. We value and celebrate the uniqueness of individuals and the different perspectives they provide. We offer equal opportunity employment regardless of race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, disability status, age, marital status, or protected veteran status.