Medical Content Analyst

The Medical Content Analyst researches and identifies Medicare, Medicaid, and other medical coding and billing documents to determine claim denial criteria for our automated claims editing solution used by medical insurance payers across the United States. Clinical content may include additions, deletions, or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service limitations, and other clinical content criteria.

Analyst responsibilities include providing written and oral presentations to the Medical Director and other clinical colleagues to reach consensus on proposed denial criteria, offering clinical content support to our customers as needed, performing data entry of clinical content updates into the database, and solving issues related to inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules. The analyst will make recommend...