Edit Configuration Analyst - Research Analytics

The Edit Configuration Analyst I performs research on editing concepts and analyzes related claims data, applying coding standards, industry knowledge, and federal regulations to ensure accurate billing practices.

This role is responsible for conducting research, analytics, and testing activities, and presenting clear, concise findings to internal stakeholders, including Physician and Senior Leadership teams.

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  Review and analyze billing for medical appropriateness and accuracy of charges

  
  
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  Research and interpret coding and billing standards

  
  
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  Perform job-specific functions, including:

  
  
  
  
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    Data analysis using SQL

    
    
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    Testing procedures for editing logic

    
    
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    Resolving incorrect results

    
    
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    Researching billing and coding concepts

    
    
  
  
  
  
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  Prepare clear and concise findings and documentation

  
  
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  Produce detailed and accurate reports

  
  
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  Assist with internal claim recommendations

  
  
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  Communicate research and analytics results to cross-functional teams

  
  
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  Support clinical education initiatives for internal staff

  
  
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  Monitor and summarize trends, regulatory updates, and billing changes

  
  
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  Partner with management to support departmental goals

  
  
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  Collaborate across disciplines and departments

  
  
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  Ensure compliance with HIPAA regulations and requirements

  
  
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  Demonstrate alignment with company core competencies and values

  
  
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  Perform other duties as assigned

  
  
• Please note due to the exposure of PHI sensitive data - this role is considered to be a High Risk Role.
• The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

This position operates independently with minimal supervision while managing multiple projects simultaneously. Work is varied and moderately complex, with more complex issues escalated to higher levels.

The role requires application of industry knowledge, business principles, and operational processes to support accurate claims editing and billing practices.

Compensation

The salary range for this position is $70-75k annually. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.