Public Consulting Group, Inc. (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,500 professionals in more than 60 offices worldwide. PCG’s Education practice offers consulting services and technology solutions that help schools, school districts, and state education agencies/ministries of education to promote student success, improve programs and processes, and optimize financial resources. To learn more, visit http://www.publicconsultinggroup.com/education/.
Claims Analysts work in a deadline-oriented, fast paced environment as part of a growing team. The team goal is to provide superior service to school districts and state departments in the area of federal Medicaid claiming. Claims Analysts have familiarity with billing health claims and can quickly learn PCG's web-based technologies. Claims Analysts focus on quality control in the claiming process and conducting user acceptance testing on our propriety claiming software with an unwavering commitment to quality and compliance. Claims Analysts are responsible for analyzing, auditing, and investigating their assigned projects/clients claiming process in order to ensure quality, resolve matters, and provide strategic solutions.
Review and troubleshoot health claims, Remittance Advices, and Medicaid eligibility files sent to state Medicaid agencies for PCG clients utilizing Microsoft Access, Business Intelligence reporting, and proprietary systems designed by PCG.
Perform detailed analysis on claims and payment information.
Provide strategic solutions when errors arise.
Create and analyze complex ad-hoc reports for internal and external stakeholders.
Oversee testing initiatives on proprietary systems designed by PCG, develop testing plans for software releases.
Write development specifications for IT software and reporting enhancements.
Independent, logical, strategic thinker with high focus, strong attention to detail and disciplined work ethic.
Inquisitively analytical, unyielding problem solving skills and able to interpret complex documents. Demonstrated time management and organizational skills, ability to manage multiple deadlines and projects.
Intermediate proficiency in Microsoft Access and Excel.
Demonstrated excellence in technological roles and ability to quickly understand and adopt new technologies.
Effective written and verbal communication and presentation style.
Quality control auditing and analysis experience required.
3-5 years of similar work experience required.
Healthcare claiming experience preferred.
Experience with Business Intelligence (report writing) a plus.
School district (K-12) knowledge a plus.
Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.