Clinical Rules Management Analyst

Job Summary

A company is looking for a Clinical Rules Management Analyst.

Key Responsibilities

• Collaborate with clinical staff to develop and implement systems that improve patient outcomes
• Conduct regular system audits to ensure data accuracy and quality
• Proactively monitor updates to coding systems and ensure timely implementation of changes

Required Qualifications

• Bachelor's/associate's degree plus a minimum of 5 years' relevant work experience
• Good understanding of specialty benefit management business
• Project management skills to manage multiple time-sensitive tasks
• Proficiency with Microsoft Office Suite
• Knowledge of ICD-10 and CPT coding assignments for billing