Related skills
cms data analysis sql jira excel📋 Description
- Research and interpret CMS, CPT/AMA payer policies.
- Identify error areas for automated logics to prevent overpayments.
- Translate edits from concept to spec; test and validate data.
- Develop claims editing logics to promote payment accuracy.
- Collaborate with Content, Engineering, and Data teams.
- Meet weekly productivity and quality goals while working remotely.
🎯 Requirements
- 8+ years in healthcare; familiar with medical coding.
- Experience with a payer or editing vendor.
- Payment accuracy knowledge (pre- and post-payment).
- Intermediate Excel skills: pivot tables, VLOOKUP.
- Understanding CMS 1500 and UB-04; claims workflow.
- Experience reading Medicare/Medicaid data and policy (CCI, NCDs).
🎁 Benefits
- Remote-friendly with home office stipend.
- Equity and 401(k) matching.
- Unlimited PTO and comprehensive health plans.
- Wellness reimbursements.
- Mental and physical wellness support (TalkSpace, Teladoc, One Medical).
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