Laboratory Corporation of America Clinical Content Project Analyst in Montvale, New Jersey
Labcorp is recruiting a Clinical Content Project Analyst for a dynamic team. This person can be a Remote based employee.
The BeaconLBS Clinical Team Clinical Analyst supports the development and implementation of BeaconLBS's lab benefit management clinical program. The mission of BeaconLBS is to provide health plans with point-of-care lab-ordering decision-support technology on the cloud and interfaced with lab and EHR test ordering platforms with the goal of improving the patient's clinical and cost experience by improving the quality and cost of lab testing.
The Clinical Content Analyst collaborates cross-departmentally, and has interaction with Product Development, IT, Lab Network Management, and Operations. The Clinical Content Analyst plays a critical role in the content development and maintenance process of clinical coding content. Under direction of the VP Clinical Operations, the analyst will facilitate the development, maintenance, QA, and delivery of the medical coding policies and claims pathways. In addition to content development, the analyst will be responsible for maintaining clear and concise documentation of all pathways algorithms, recommendations, and supporting data.
The Clinical Content Analyst provides clinical coding input to certain activities including but not limited to, the creation and translation of clinical rules to the lab benefit management application, mapping of laboratory test codes, creating clinical SOPs, providing coding recommendations during the test mapping process and the Business Requirement story writing in support of claims editing functions and developing coverage policies. The Clinical Analyst also assists clients and lab partners with marketing and communication, operational readiness activities, and on-boarding activities. Specific responsibilities follow:
Ability to comprehend, interpret, analyze, and communicate clinical and laboratory data, including but not limited to ICD10, CPT codes, LOINC, and SNOMED
Manage development and maintenance of clinical coding content with Team Leads including development of policy rules
Support on-boarding and operational readiness of Network labs
Support implementation activities for health plan clients, including clinical policy development and, development of communications to physicians, development of training materials, and more
Support other activities for BeaconLBS including analyze data, create and deliver presentations, provide input into system/product strategy, report statuses and issues to senior management, manage and resolve issues, and meet client commitments
Conduct special projects/studies; participates in various work groups upon request
Ensure adherence to all CMS Claims Processing Legislative and Regulatory requirements
Additional Skills Requirements:
Demonstrate clear and articulate verbal, written, and presentation skills with good command of the English language
Ability to manage multiple initiatives and collaborate cross-functionally
Self-starter/self-motivated, detail oriented, capable of meeting deadlines, works independently to pursue solutions with minimal direction
Bachelor's degree or related experience in an insurance or related field
Minimum five (5) Years of claims, insurance or health care compliance required. Must have working knowledge of health plan and CMS claims processing requirements and workflow.
Professional Coding Certification, specifically CPC or CCS, desired
Certified Risk Coder (CRC) or additional coding certification(s) desired
Knowledge of medical terminology preferred
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, national origin, sexual orientation, gender identity, disability or veteran status.