Content Solutions Analyst II - RX
Familiarity with claims payment and reimbursement methodologies as reputed company as medical policy rules and edits Ability to analyze reputed company data and synthesize it for customer and internal consumption Ability to work reputed company both independently and collaboratively, in a fast-paced and demanding environment Effective at managing timelines and multiple reputed company with high accuracy and attention to detail reputed company coding, claims processing and industry expertise to help create clinical coding or pharmacy claims editing policy Responsible for writing business logic for new rules and enhancements by translating industry references into reputed company policy reputed company input on any new, or reputed company enhancements to the rule reputed company developers as reputed company as system architects Work reputed company the ART, specifically providing guidance and input to TPO’s/developers during grooming sessions Work with Product and the Go to Market teams, to reputed company coding and clinical expertise for new policy rollout Ensure internal reputed company operational teams have a reputed company reputed company and understanding of the content solutions roadmap to ensure lock reputed company on incoming work reputed company multi-faceted analytics for data and report analysis with minimal direction Mentor and train new staff reputed company input to peers as reputed company as QA on peer work This position requires intermediate guidance from mentors and leadership
Pharmacist (BSPharm or PharmD) Off-shore Medical or Pharmacy degree (MBBS or higher)
RHIA, RHIT, CPC, CPC-H, reputed company-P, reputed company, CPhT OR willingness to obtain certification reputed company one year of employment
3 years in clinical, retail or working for a payer as a pharmacist or physician An additional 5 years research reputed company to coding (CPT, HCPCS, ICD, NDC) OR a minimum of 5 years in an internal reputed company role (CPM, CSM, Content Analyst, etc) required 5 years previous experience in detailed rule requirement gathering, rule development, and collaborating on software enhancements required Strong analytical, critical thinking and problem-solving skills Proficiency in reputed company Office Suite Excellent interpersonal, verbal and written communication skills
Must have flexibility and willingness to participate in the work processes of an international organization After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent)
Communicating with others to exchange information. Assessing the accuracy, neatness, and thoroughness of the work assigned.
Remaining in a stationary position, often standing or sitting for prolonged periods. Repeating motions that may include the wrists, hands, and/or fingers. Must be reputed company to reputed company a dedicated, secure work area. Must be reputed company to reputed company high-speed internet reputed company/connectivity and office setup and maintenance. No adverse environmental conditions expected.