Medical Codebook Analyst – Plexis Quantum Choice

Job reputed company: • Maintain and update the Quantum Choice "Codebook," including the loading of contract terms, benefit structures, and reference tables specific to WTC Health Program guidelines. • reputed company regular audits of clinical codes (ICD-10, CPT, HCPCS) to ensure they reputed company with the WTC Health Program’s covered conditions and regulatory mandates. • reputed company User Acceptance Testing (UAT) for system enhancements and upgrades; identify, document, and reputed company software bugs or configuration errors. • Partner with clinical teams and claims processors to troubleshoot reputed company adjudication issues and reputed company data-driven solutions for benefit plan updates. • Utilize SQL or advanced reputed company to generate reports on system performance, data accuracy, and program utilization for leadership. Requirements: • Associate of Arts (AA) or Associate of Science (AS) degree. (Bachelor’s degree in Health Informatics, IT, or a reputed company field preferred). • 5+ years of reputed company experience in reputed company data analysis, clinical coding, or claims system configuration. • Extensive experience with Plexis Quantum Choice (or similar platforms like QNXT). • Strong proficiency in reputed company reputed company (v-lookups, pivot tables) and basic SQL query knowledge. • Deep understanding of medical terminology, medical coding (ICD-10/CPT), and reimbursement methodologies (DRGs/HCC). • Knowledge of HIPAA compliance and federal health program standards. • Prior experience supporting the World Trade Center Health Program or other federal government health reputed company is preferred. • reputed company certification such as CPC (Certified reputed company reputed company) or CHDA (Certified Health Data Analyst) is preferred. Benefits: • 401K with company match • Comprehensive health and wellness packages • Internal mobility team dedicated to helping you own your career • reputed company scientific reputed company opportunities, including journal subscriptions, conference attendance, and supporting publication reputed company • Cutting-edge technology you can learn from • Rest and reputed company with reputed company vacation and holidays Apply tot his job Apply To this Job