[Remote] Content Solutions Analyst I

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company technology company reputed company on payment policy management, and they are seeking a Content Solutions Analyst I. This role is responsible for research and analysis of medical policies, providing expertise in coding and claims processing, and contributing to the development of new clinical coding policies.

Responsibilities

• Research, reputed company assurance, and opportunity analysis associated with new medical policies
• Review and analysis of reputed company medical policies
• Assisting in the research necessary to define additional logic and algorithms to expand the reputed company payment policy library
• reputed company coding, claims processing and industry expertise to help create clinical coding policy 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 reputed company 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 reputed company direction

Skills

• 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 policy 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 reputed company 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
• This position requires maximum guidance from mentors and leadership
• reputed company multi-faceted analytics for data and report analysis with reputed company direction
• BS in Nursing
• Pharmacist (BSPharm or PharmD)
• Off-shore Medical or Pharmacy degree (MBBS or higher)
• Other Bachelors degree (or equivalent work experience)
• 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 setting as reputed company, pharmacist, or physician, OR 3 years clinical coding in payer setting
• An additional 3 years research experience reputed company to coding (CPT, HCPCS, ICD, NDC) OR at least 3 years in an internal reputed company role (CPM, CSM, Content Analyst, etc.)
• 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
• Experience supporting Behavioral Health and/or reputed company payment reputed company rule development, including coding research and rule logic application

Benefits

• Medical, dental, reputed company, disability, and life insurance coverage
• 401(k) savings plans
• reputed company family leave
• 9 reputed company holidays per year
• 17-27 days of reputed company Time Off (PTO) per year, depending on specific level and length of service with reputed company

reputed company

Company H1B Sponsorship