Clinical Analyst
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Job Summary
Supporting the development of clinical policies and payment solutions, the full-time Clinical Analyst will utilize claims analytics and medical literature to drive accurate coverage and reimbursement decisions in a remote setting.
Key responsibilities
- Apply claims analytics to identify opportunities for coverage criteria and claim edit development
- Draft, review, and maintain coverage criteria based on clinical characteristics and risk factors
- Provide clinical content support to customers in collaboration with Customer Operations as needed
Required qualifications
- Bachelor's degree in biology, nursing, health sciences, or a related field
- 5 years' experience in clinical roles such as patient care, clinical research, or payment integrity
- Demonstrated technological proficiency with software applications like MS Word, MS Excel, and project management tools
- Strong analytical skills, including experience with qualitative and quantitative data analysis
- Comfort with basic Excel functions or willingness to learn
Complete Job Description
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