Associate Claims Validation Analyst

📋 Description

• Research and interpret CMS, CPT/AMA payer policies per coding rules.
• Identify error areas to convert into automated logics.
• Move edits from concept to spec, then review, test, and validate.
• Collaborate with Content, Engineering and Data teams on edits.
• Build claims editing logic to promote payment accuracy.
• Be a self-starter and work remotely.

🎯 Requirements

• 4+ years in healthcare, familiar with medical coding and claims.
• Experience working for a payer or editing vendor.
• Payment accuracy experience with prepayment or post-payment knowledge.
• Proficient with Google Workspace, Jira, and other software.
• Strong collaboration across departments such as Engineering and Product.
• Ability to learn new tools and data analysis skills.