HIS Clinical Analyst – Population Health Methodology Groupers
New
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SolventumHealthcare Analytics
United StatesFull-TimeMiddle
Salary107,600 - 147,950 USD per year
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Job Details
- Experience
- 5+ years
- Required Skills
- Microsoft Excel
Requirements
- Bachelor's degree or applicable certifications from an accredited institution.
- 5+ years of experience in the healthcare industry in research, analytics, outpatient coding/billing, prior authorization, denials management, or claims processing.
- Knowledge of ICD-10-CM, ICD-10-PCS, HCPCS/CPT, and DRG classification.
- Understanding of claims processing workflows and reimbursement methodologies.
- Proficiency using Excel, databases, and analytical software applications.
- Familiarity with the application of AI technologies for research, analytics, and process automation.
- Ability to communicate technical and clinical information effectively.
- Experience managing multiple priorities and subject areas in a dynamic environment.
- Experience working in multicultural and cross-functional environments.
- Ability to work independently and collaboratively.
Responsibilities
- Serve as a hands-on clinical analyst, responsible for the design, development and maintenance of several proprietary Solventum methodologies.
- Perform in-depth validation and testing analysis of healthcare data to evaluate methodology behavior and identify anomalies and enhancements.
- Serve as methodology expert contributing and coordinating with the Research team efforts and providing input into research prioritization.
- Work directly with product and development teams to drive methodology enhancements by translating clinical concepts into documented, executable logic.
- Collaborate cross-functionally to integrate product concepts into software components for each methodology.
- Maintain process documentation for methodologies, producing update summaries using C&ER standards.
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