Assess current configuration, errors, workflows, active tickets, and high-volume payers; develop a
Review payer/plan structure, plan mapping, unique plan mapping, synonyms, and ongoing maintenance.
Assess why staff are selecting generic coverages and address underlying payer/plan configuration
Review HB and PB priority payers by 271 section, plan mapping, and benefit filing behavior.
Review deductibles, copays, Tier 1/Tier 2 benefits, service type mapping, and related estimate
Optimize RTE coverage auto-creation and Medicare replacement chaining where appropriate.

🎯 Requirements

RTE Certified
Active RTE type roles experience
Cadence or Prelude certification a plus

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