Bluespine is an innovative new startup in the health-IT domain. By employing cutting-edge technologies, Bluespine is developing an engine that detects errors in medical billing, which causes billions of dollars in losses across the entire industry. Bluespine can offer personalized precision by tailoring assessments to each unique medical claim, considering the relevant provider, payer, and plan, and ensuring unparalleled accuracy.
We are looking for a Payment Accuracy and Concept Lead to discover medical billing errors and fraudulent billing patterns of medical claims for commercial payers.
Utilized Bluespine platform to develop and enhance new audit concepts using healthcare. Leads concept creation across multiple audit verticals, collaborating with R&D for testing
Responsibilities
- Leverages the Bluespine platform to develop and refine new audit concepts in healthcare. Leads concept creation across multiple audit verticals.
- Works closely with Medical Coders, Data Sciences, and Engineering teams to ensure alignment and drive impactful results
- Lead in-depth research of new ideas and concepts
- Extensive knowledge of medical terminology, medical records, health information management, medical coding, DRG methodologies, CPT/HCPCS coding guidelines, physician specialty guidelines, reimbursement programs, claims adjudication processes, member contract benefits, and provider billing systems and practices.
- Previous auditing or consulting experience in a provider or payer environment is preferred
Advantages
- Registered Nurse required; Bachelor's or Graduate degree
- Previous auditing or consulting experience with self-insured companies
Skills Required
- Extensive knowledge of medical terminology and medical records
- Knowledge of medical coding and DRG methodologies
- Previous auditing or consulting experience in a provider or payer environment
- Registered Nurse required
- Bachelor's or Graduate degree
What We Do
Team8 is a global venture group with deep domain expertise that creates companies and invests in companies specializing in enterprise technologies, cyber, AI, fintech and digital health. Leveraging an in-house, multi-disciplinary team of company-builders integrated with a dedicated community of C-level executives and thought leaders, Team8’s model is designed to outline big problems, ideate solutions, and help accelerate success through technology, market fit and talent acquisition. Team8’s leadership team represents serial entrepreneurs, industry pioneers and the former leadership of Israel’s elite tech and intelligence Unit 8200. Founded in 2014, Team8 is backed by global companies including Microsoft, Walmart, Cisco, Barclays and Moody’s, among others. To learn more about Team8 visit www.team8.vc
