Real Time Eligibility Healthcare Analyst

Chartis
United States
RemoteCareer-pivot friendly

Who this role is best for

Strong fit for healthcare domain experts who prioritize technical configuration and process optimization. The role emphasizes RTE certification, payer/plan mapping, and collaboration with Patient Access teams in a remote U.S. setting.

Best fit for

  • Candidates with RTE certification and experience in payer/plan configuration and workflow optimization
    — “Must be RTE Certified and been in active RTE type roles.”
  • Individuals who can partner with Patient Access teams to develop education and standard processes
    — “Partner with Patient Access to develop payer selection guidance, Registration education, job aids, and standard workflows.”

Things to consider

  • The role requires a temporary commitment of 3-6 months with no indication of long-term potential.
    — “Real Time Eligibility Analyst (3-6 month contract)”
  • The candidate must be prepared to address underlying configuration and education gaps affecting claims routing.
    — “Generic Commercial utilization has already been identified as contributing to claims routing to No Response buckets.”

How to stand out

  • Highlight experience with RTE assessment and prioritization in your resume and interview responses.
    — “Assess current configuration, errors, workflows, active tickets, and high-volume payers.”
  • Demonstrate expertise in payer/plan mapping and benefit filing behavior in your application materials.
    — “Review payer/plan structure, plan mapping, unique plan mapping, synonyms, and ongoing maintenance.”
  • Showcase your ability to optimize coverage auto-creation and Medicare replacement chaining.
    — “Optimize RTE coverage auto-creation and Medicare replacement chaining where appropriate.”
  • Emphasize your ability to create documentation and knowledge transfer plans for sustainment.
    — “Establish monitoring, documentation, ownership, and knowledge transfer so the internal team can maintain the environment.”
Pace · SteadyCollaboration · HighAutonomy · MediumDecision Impact · Team

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • ability to assess current configuration and develop prioritized roadmap
  • review payer/plan structure and benefit filing behavior
Typical background
RTE Certifiedactive RTE type roles

Skills & requirements

Required

Real Time Eligibility (rte) CertificationHealthcare EligibilityWorkflow OptimizationCoverage Creation

Preferred

Cadence Or Prelude Certification

Stack & domain

RTE Assessment And PrioritizationPayer And Plan Record StrategyGeneric Coverage UtilizationMajor Payer ReviewBenefit And Service Type MappingCoverage Creation And AutomationCoverage Manager And COBRegistration Workflow And EducationSustainmentTapestry IntegrationRTECadencePreludeHealthcare

About the role

Original posting from Chartis via Ashby

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.

Source: Chartis careers (Ashby)

Similar roles