Real Time Eligibility Healthcare Analyst
About The Position
Chartis is seeking a Real Time Eligibility Analyst for a 3–6 month contract. The analyst will assess and optimize real-time eligibility (RTE) configuration and workflows, focusing on payer and plan records, benefit and service type mapping, coverage creation, Coverage Manager and coordination of benefits (COB), and registration processes. The role will collaborate with Patient Access to improve payer selection guidance, staff education, job aids, and standard workflows. It will also establish monitoring, documentation, ownership, and knowledge transfer to support ongoing internal maintenance. The position may be performed remotely. Tapestry integration experience is a plus but is not required.
Requirements
- Must be RTE certified.
- Must have worked in active RTE-type roles.
Nice To Haves
- Cadence or Prelude certification.
- Tapestry integration experience.
Responsibilities
- Assess current RTE configuration, errors, workflows, active tickets, and high-volume payers; develop a prioritized roadmap based on volume, impact, urgency, and patient experience.
- Review payer and plan record structures, plan mapping, unique plan mapping, synonyms, and ongoing maintenance.
- Investigate generic coverage selection and address underlying payer and plan configuration, workflow, and education gaps.
- Review major hospital billing (HB) and professional billing (PB) priority payers by 271 section, plan mapping, and benefit filing behavior.
- Review deductibles, copays, Tier 1 and Tier 2 benefits, service type mapping, and related estimate accuracy issues.
- Optimize RTE coverage auto-creation and Medicare replacement chaining where appropriate.
- Review Coverage Manager changes, filing order, coordination of benefits (COB), and related payer selection workflows.
- Partner with Patient Access to develop payer selection guidance, registration education, job aids, and standard workflows.
- Establish monitoring, documentation, ownership, and knowledge transfer so the internal team can maintain the environment.
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What This Job Offers
Education Level
No Education Listed
