Subject Matter Expert - Analytics

Specialty Rules Analyst: (4 requirements)

Company Overview

Our company is a leading provider of healthcare solutions, dedicated to improving patient outcomes and streamlining medical processes. We are committed to innovation, excellence, and providing top-notch services to our clients. Join our team and be a part of a dynamic and forward-thinking organization.

Position Overview: We are seeking an experienced and talented SME to join our Business specializing in US Healthcare Revenue Cycle Management. In this crucial role, you will be responsible for development, implementation, and optimization of BI solutions that drive actionable insights and support informed decision-making within the healthcare revenue cycle processes.

The Data Analyst position will give you the following opportunities

Chance to learn new skills such as cleaning, analyzing, interpreting, and displaying data using different approaches

uncovering key insights that lead to better-informed and successful decision-making

Opportunity to learn the transformation of raw data into meaningful statistics, information, and explanations

Responsibilities

• Analyze medical records to identify any edits that can potentially deny the claim based on ICD-10, CPT, modifiers, LCD, NCD, and all applicable coding guidelines.
• Understand which databases to access and research to provide/write an edit to a denied claim.
• Strong data analysis skills.
• Proficient in multi-specialties of medical coding, especially in Pathology, Radiology, ED, EM, Surgery, Anesthesia, OBGYN, Behavioral Health, Maternal and Fetal monitoring.
• Certification from AHIMA or AAPC.
• Minimum of 4 years of working experience.
• Experience in managing coding denials of multispecialty is desirable.