IBR Policy and Content Development Analyst

📋 Description

• Review, update, and enhance existing audit concepts according to established review schedules and
• Analyze changes in healthcare regulations, medical coding guidelines, reimbursement methodologies
• Interpret and incorporate payer-specific reimbursement rules, medical necessity criteria, and
• Research and apply state-specific Medicare and Medicaid provider manuals, regional regulatory
• Evaluate payer policies and claims trends to identify coverage gaps, reimbursement inconsistencies
• Ensure audit concepts are appropriately developed and maintained across Medicaid, Medicare, and

🎯 Requirements

• At least three years of experience in healthcare payment integrity, facility claims auditing, or a
• At least one of the following credentials: Registered Health Information Administrator (RHIA)
• Demonstrated ability to interpret complex healthcare regulations, payer guidelines, and medical
• Strong understanding of Medicare and commercial coding rules, reimbursement regulations
• Broad knowledge of medical claims billing and payment systems, facility billing guidelines
• In-depth understanding of different facility reimbursement models and commercial and government

🎁 Benefits

• Annual salary ranging from $85,000 to $110,000, depending on skills, experience, qualifications
• The flexibility to work remotely from anywhere within the United States.
• Access to comprehensive medical insurance options.
• Benefits designed to support employees' overall health and well-being.
• Access to FSA and HSA options to help manage eligible healthcare expenses.
• A 401(k) plan with employer matching contributions.