Registered Nurse Content Analyst

Job Summary

Responsible for research, quality assurance, and opportunity analysis related to medical policies, the full-time Remote Content Analyst II will provide coding expertise, write business logic for new rules, and maintain an accurate medical policy library.

Key responsibilities

• Provide coding and industry expertise to create and maintain clinical coding edits
• Write business logic for new rules and enhancements by translating industry references into policy
• Review and identify changes to medical policies to ensure an accurate and current policy library

Required qualifications

• Active professional license as a Registered Nurse (BSN preferred), Pharmacist (BSPharm or PharmD), or a Bachelor's degree in a healthcare-related field
• Professional certification (RHIA, RHIT, CPC, CPC-H, CPC-P, or CCS-P) preferred or willingness to obtain within one year
• Minimum of 5 years of experience in a clinical setting or 6 years of clinical coding experience
• Minimum of 3 years of experience in internet-based research related to medical codes
• Familiarity with claims payment methodologies and medical policy rules and edits