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IQ Analysis Team Lead - Lakeland, Florida

Overview

As a member of the corporate team, you’ll focus on enhancing the relationship with our clients as we provide outstanding business solution services. Within departments like Accounting & Finance, Human Resources, and Engineering, Conduent is actively staffing all teams with roles like Recovery Analyst, Client Services Specialist, and Senior Management Consultant. At Conduent, we give our employees the opportunity to further develop their career skills with the intention of growing them into leaders within the organization.

  • Full Time
  • Experienced
  • Professional Development Opportunities

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Success Profile

What will make you successful at Conduent?
Check out the traits we’re looking for and see if you have the right mix.

  • Adaptable 9
  • Detail-Oriented 9
  • Multi-Tasker 8
  • Strategic 10
  • Expressive Presenter 6
  • Conceptual 4
Traits are on a scale of 1 to 10

Addtional Traits

  • Insightful
  • Organized
  • Consistent
  • Efficient
  • Focused
  • Logical
  • Responsible
  • Versatile

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Rewards

  • Healthcare

    Conduent is proud to offer comprehensive and competitive benefits that reflect the value of our employees. Benefits will differ by country, please contact your recruiter for details specific to your location.

  • Balance

    Maintaining a work/life balance is the key to success.

  • Collaboration

    Department learning opportunities and company-wide digital knowledge share.

  • Compensation

    Competitive salaries.

  • Family Support

    Additional resources to support employees with families.

  • Professional Development

    Conduent offers programs to help advance the careers of our employees.

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Responsibilities

Description
Summary: The IQ Analysis Department reviews out of network bills to determine the reasonableness of each charge. The Team Lead is responsible for training all new hires and maintaining training materials. The Team Lead will QA the IQA team and issue monthly reports to management. The Team Lead will negotiate with providers and facilities according to state guidelines and regulations. The Team Lead is responsible for maintaining Turn Around Time (TAT), client specific instructions and manual application of discounts.
Essential Duties and Responsibilities
Responsible for training new hires.
Responsible for maintaining the IQA Training Manual
Responsible for QA of the IQA team based on department Policies & Procedures
Negotiate discounts based on client direction, state guidelines and like services
Responsible for all Manual queues
Responsible for Prompt Pay Product
Responsible for tracking department Turn Around Time
Responsible for Pre Negotiations
Ability to interpret reviewed bills and reason codes to determine if the bill is negotiable
Effectively build and maintain relationships with providers and facilities to secure future discounts and/or long-term contracts
Ability to effectively communicate and defend to providers and clients in writing and on the phone the basis for the methodology used to accomplish the reduction of charges 
Assists in the composition of department policies and procedures regularly 
Maintains a reference library of company and industry reimbursement policies
Negotiates long-term provider discounts per client or Conduent book of business
Qualifications:To perform this job successfully, an individual must be able to perform each essential duty completely and with ease. The specialist must have at least five years of claims experience. Experience should have encompassed a variety of reduction methodologies from different sources.  Applicant must be willing to take on special projects and new assignments as needed. Applicant must have telephonic communication experience.
Education and/or Experience:
High school diploma
5 years’ healthcare experience
Salary:
Competitive Hourly Pay
Incentive/Bonus: RBC Plan
Computer Skills:
Comprehensive understanding of Internet, Windows interface, and software applications.
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first:click here to access or download the form.

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  • Service Delivery Healthcare, Lakeland, Florida, United StatesRemove