Healthcare Content Program Lead

TBC Corporation

6d • $122,425 - $183,638

About The Position

Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position. The Healthcare Content Program Lead is a key contributor to the operational success, customer consultation, and ongoing optimization of Lyric’s content-based claim leveling programs. This role serves as a strategic and consultative partner to payer customers as they transition from sales into implementation and ongoing operations, ensuring accurate interpretation, adoption, and sustained performance of program content. This role combines deep expertise in medical coding, claims processing, and reimbursement methodologies with strong customer-facing and analytical capabilities. The Healthcare Content Program Lead will regularly engage with customers to review claim examples, explain edit behavior, and assess program performance over time. In parallel, this role will collaborate closely with Product Strategy, Clinical Operations, Implementation, and Customer Success teams to refine existing programs and support the development of future content programs focused on other complex claim leveling and reimbursement assessment areas.

Requirements

• Bachelor’s degree in healthcare administration, health information management, nursing, or a related healthcare field.
• Active AAPC Certified Professional Coder (CPC) credential required.
• Minimum of five (5) years of experience working with medical claims, coding, billing, reimbursement methodologies, or payment integrity, either within a health plan or as a payment integrity vendor.
• Experience supporting or operationalizing content-based claim edits or payment accuracy programs.
• Proven ability to independently lead customer meetings and translate detailed claim behavior into clear, actionable insights.
• Strong analytical skills with the ability to identify trends, assess performance, and recommend improvements.

Nice To Haves

• Experience supporting Emergency Department claims, E/M leveling, or other complex facility or professional reimbursement scenarios.
• Prior experience working closely with product, implementation, or customer success teams.
• Experience with prepayment or post-payment payment integrity solutions.

Responsibilities

• Serve as the primary consultative lead for customers operating Lyric’s Emergency Department content program, supporting onboarding, implementation, and ongoing program operations.
• Lead recurring customer meetings and operational reviews to explain program logic, review claim outcomes, and assess performance trends.
• Collaborate with and support Go-To-Market and solution design teams during the sales process
• Partner with Implementation and Customer Success teams to support customers transitioning from the sales cycle into production use of the solution.
• Work directly with customers to review example claims and explain claim behavior, including coding, billing, and reimbursement drivers.
• Support customers in addressing operational questions and performance concerns without direct provider engagement.
• Monitor edit performance, quality, and outcomes over time, identifying trends, variances, and opportunities for improvement.
• Analyze claims data and customer feedback to assess program effectiveness and operational impact.
• Provide structured insights and recommendations to Product Strategy and Clinical Operations teams to inform program refinements, enhancements, and roadmap decisions.
• Support testing, validation, and rollout of content updates to ensure accuracy, defensibility, and alignment with customer expectations.
• Contribute to the research, design, and development of new content-based leveling and assessment programs
• Perform hands-on analysis of claim examples during program development to validate logic, identify edge cases, and refine content prior to release.
• Research coding guidelines, reimbursement methodologies, and payer practices to support the expansion and maturation of future programs.
• Participate in cross-functional ideation and discovery efforts to assess market demand, customer needs, and operational feasibility of new programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level