Content Business Analyst -Health

Experian

1d•Remote

About The Position

Experian Health is seeking a Content Business Analyst to interpret medical rules, regulations, fee schedules, and edits from various payers. This role involves understanding and manipulating payer data to build and maintain coding and financial tables that support Experian Health product logic. The analyst will navigate complex regulatory scenarios, analyze Medicaid fee schedules, and ensure the accuracy of payer-specific edits to maximize product efficiency. The position also involves leveraging internal loading systems and supporting the integration of automation and AI technologies.

Requirements

2-3 years of healthcare reimbursement and coding experience is preferred.
Good knowledge and experience in using Salesforce, Atlassian JIRA, Microsoft 365 applications.
Great proficiency in Excel and other data analytics tools.
High-level knowledge of CPT, HCPCs, and ICD-10 coding language to ensure the accuracy of coding edit files.
Adaptable to changing environment and workload when necessary.

Responsibilities

Interpret medical rules, regulations, fee schedules, and edits posted by payers (e.g., CMS, State Medicaid plans, Tricare, commercial insurance plans).
Understand and manipulate payer data to build federal, state, and commercial coding and financial tables that support Experian Health product logic.
Monitor and maintain the tables due to unpredictable payer updates.
Navigate complex and evolving regulatory scenarios.
Analyze and maintain Medicaid master fee schedules.
Think through situations independently and in collaboration with others.
Maximize the efficiency and use of our product solutions by properly maintaining payer specific edits.
Leverage internal loading systems to routinely load advanced edit tables in testing and production environments.
Support and navigate automation and AI technologies.