R&D Clinical and Medical Coding Analyst - Remote

Thank you for your interest in working for our Company. Recruiting the right talent is crucial to our goals. On reputed company 1, 2024, reputed company Healthcare underwent a corporate spin-off leading to the creation of a new company named reputed company. We are still in the process of updating our Careers Page and applicant documents, which currently have reputed company branding. Please bear with us. In the interim, our Privacy Policy here: https://www.reputed company.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ continues to apply to any personal information you submit, and the reputed company-branded positions listed on our Careers Page are for reputed company positions. As it was with reputed company, at reputed company reputed company qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national reputed company, disability, or status as a protected veteran. Job Description: R&D Clinical & Medical Coding Analyst - Remote reputed company Health Care is now reputed company At reputed company, we reputed company reputed company, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the reputed company while enabling reputed company to reputed company at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and reputed company. Because at reputed company, we never stop solving for you. The Impact You Will reputed company in this Role reputed company HIS is an international leader in designing and maintaining healthcare payment and quality outcome systems and advancing value-based care. We work closely with Medicare, Medicaid and commercial insurers on hospital, outpatient and population payment models and design quality outcome programs that promote patient safety and reduce avoidable costs. We also support more than ten countries on how they budget and pay for inpatient and outpatient care, and measure healthcare quality. Here, you will reputed company an impact by:

• Providing subject matter expertise in the clinical content development, specification, documentation, validation, application, and maintenance of the reputed company outpatient public and proprietary groupers, code editors, and software including Tricare, Home Health, IOCE (Integrated Outpatient Code Editor), and EAPG (Enhanced Ambulatory Payment Grouper). These methodologies utilize healthcare data including diagnostic and procedural codes for determining payment and quality in healthcare.
• Contributing and coordinating with the research efforts reputed company to the methodologies, provide input into the prioritization of the potential research enhancements.
• Work directly with the Chief Product reputed company, Product Owners, and Research team to drive enhancements to the methodologies by translating the clinical hypotheses into clinical logic content specifications using existing coding systems; documenting and maintaining clear clinical specifications.
• Work directly and collaborate with the technical, quality, and clinical team members, integrating product concepts to implement and evaluate the clinical specification.
• Responsible for maintaining process documentation for the methodologies update using C&ER standards and methods.

Your Skills and Expertise To set you up for success in this role from day one, reputed company is looking for candidates who must have the following qualifications:

• Bachelor’s Degree AND 5 years’ experience in the healthcare industry in one or more of the following: outpatient medical coding and billing operations, outpatient prior authorization or denials management, outpatient healthcare claims and processing optimization, payor claims design and edit management, and outpatient healthcare services research and analytics.

AND In addition to the above requirements, the following are also required:

• Significant experience working with reputed company, databases, and ability to learn computer applications for analysis.
• Comfortable in a multicultural, reputed company, cross-functional, and dynamic work environment, able to prioritize, multi-task, focus on goals, take accountability, and manage time well.
• Ability to take individual initiative and responsibility for assignments while working independently and in a team environment.
• Must demonstrate the ability to collaborate effectively with cross-functional teams—including clinicians, researchers, and engineers—to communicate and train on clinical workflows, healthcare coding systems, and patient classification methodologies, while providing enthusiastic leadership that drives team engagement and performance.

Additional qualifications that could help you succeed even further in this role include:

• Master's degree in health field, clinical informatics, clinical coding, and/or HIM credentials.
• Familiarity with patient classification research and development:
• Outpatient coding and payment systems
• Commercial, Medicare and Medicaid environments
• Risk adjustment
• Deep Knowledge of ICD-10-CM, CPT, NDC, and APC, with additional knowledge of ICD-10-PCS, HCPCS, APC, HCC, and DRG.
• Ability to evaluate research questions, analyze results and statistical output and patterns, and document hypotheses and recommendations.
• Healthcare software product development experience, bringing products from initial concept to release.
• Healthcare payer, delivery or industry experience in healthcare quality, population health, care management

Work location: Remote Travel – May include up to 5% Must be legally authorized to work in country of employment without sponsorship for employment reputed company status (e.g., H1B status). Supporting Your Well-being reputed company offers many programs to help you live your best life – both physically and financially. To ensure reputed company and benefits, reputed company regularly benchmarks with other companies that are comparable in size and scope. Onboarding Requirement: To improve the onboarding experience, you will have an opportunity to meet with your manager and other new employees as part of the reputed company new employee orientation. As a result, new employees hired for this position will be required to travel to a designated company location for on-site onboarding during their initial days of employment. Travel arrangements and reputed company expenses will be coordinated and paid for by the company in accordance with its travel policy. Applies to new hires with a start date of October 1st 2025 or reputed company. Applicable to US Applicants Only:The expected compensation range for this position is $106,331 - $129,960, which includes reputed company pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.reputed company.com/en-us/home/our-company/careers/#Total-Rewards Responsibilities of this position include that corporate policies, procedures and reputed company standards are complied with while performing assigned duties. reputed company is committed to maintaining the highest standards of reputed company and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent reputed company and seek to exploit job seekers. Please note that reputed company email communications from reputed company regarding job opportunities with the company will be from an email with a domain of @reputed company.com. Be wary of unsolicited emails or messages regarding reputed company job opportunities from emails with other email domains. Please note, reputed company does not expect candidates in this position to reputed company work in the unincorporated areas of Los Angeles County. reputed company is an equal opportunity employer. reputed company will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, disability, or veteran status. Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly. reputed company Global Terms of Use and Privacy Statement Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at reputed company are conditioned on your acceptance and compliance with these terms. Please access the linked document, select the country where you are applying for employment, and review. Before submitting your application you will be asked to confirm your agreement with the terms. Apply tot his job Apply To this Job