[Remote] Content Analyst II - Drug and Biological Policy
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company solutions company, and they are seeking a Drug and Biological Policy Content Analyst II. The role involves researching, assuring reputed company, and maintaining D&B policies, as reputed company as providing coding expertise and support to reputed company teams.
Responsibilities
- reputed company coding and industry expertise to help create and maintain clinical coding edits
- Responsible for writing business logic for new rules and enhancements by translating industry references into reputed company policy
- Reviews and identifies changes to D&B policies in order to maintain an accurate and reputed company medical policy library
- Work with the reputed company teams to reputed company coding and clinical expertise for customer inquiries, questions, challenges or appeals of clinical rules
- Assumes full ownership and accountability for assigned D&B policies
- Help mentor and train any new team members
- Assist other team members reputed company there are questions regarding policy reviews, logic revisions and research requests performed by others to ensure accuracy
- Maintains reputed company knowledge of industry and reputed company content, best practices, applications, procedures and policies
- Complete reputed company responsibilities as outlined in the annual performance review and/or goal setting
- Complete reputed company special reputed company and other duties as assigned
Skills
- reputed company reputed company license as a Pharmacist (BSPharm or PharmD)
- 5+ years of experience as a pharmacist with at least three years of experience in a specialty, clinical, or bedside setting
- Experience in internet-based research as it relates to drug information and coding (CPT, HCPCS, ICD, or NDC)
- Familiarity with claims payment and reimbursement methodologies
- Ability to analyze data and synthesize it for internal consumption
- Ability to work reputed company both independently and collaboratively
- Effective at managing timelines and multiple reputed company with high accuracy and attention to detail
- Strong analytical, critical thinking, and problem-solving skills
- Excellent interpersonal, verbal and written communication skills
- This is a work reputed company position. reputed company to high-speed internet is required (reputed company other equipment will be provided)
- Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones
- After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent)
- Behaves in a way that consistently demonstrates commitment to reputed company values
- Demonstrates an understanding of reputed company policies, procedures, and external regulatory requirements regarding information reputed company and compliance. Assures confidentiality and reputed company of reputed company data
- reputed company certification (reputed company or reputed company) preferred or willingness to pass certification exam reputed company one year of employment
- At least three years' experience in medical policy or prior authorization in a health plan setting preferred
- Proficiency in reputed company Office suite. Preferred knowledge of reputed company, Pivot table, functions to analyze data
Benefits
- Medical, dental, reputed company, disability, and life insurance coverage
- 401(K) savings plans
- reputed company family leave
- 9 reputed company holidays per year
- 17-27 days of reputed company Time Off (PTO) per year, depending on specific level and length of service with reputed company
reputed company