Medical Codebook Analyst – Plexis Quantum Choice

Job not on LinkedIn

🕒 May 22

🇺🇸 United States – Remote

💵 $48.5k - $65.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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General Dynamics Information Technology

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1954

🔒 Cybersecurity

🤖 Artificial Intelligence

Defense • Cybersecurity • Artificial Intelligence

General Dynamics Information Technology is a company at the forefront of technological innovation, offering a wide range of services including consulting, digital modernization, and application services. The company is heavily involved in implementing solutions related to artificial intelligence, cloud computing, cybersecurity, high-performance computing, and quantum technologies. GDIT is committed to supporting government and defense sectors, providing mission-critical services such as logistics and supply chain management, intelligence, and homeland security. The company also focuses on diverse and inclusive hiring practices and actively promotes employee well-being. Through its digital accelerator solutions and pioneering use of emerging technologies, GDIT aims to propel agencies' missions forward and address complex technological challenges.

📋 Description

• Maintain and update the Quantum Choice "Codebook," including the loading of contract terms, benefit structures, and reference tables specific to WTC Health Program guidelines • Perform regular audits of clinical codes (ICD-10, CPT, HCPCS) to ensure they align with the WTC Health Program’s covered conditions and regulatory mandates • Lead User Acceptance Testing (UAT) for system enhancements and upgrades; identify, document, and track software bugs or configuration errors • Partner with clinical teams and claims processors to troubleshoot complex adjudication issues and provide data-driven solutions for benefit plan updates • Utilize SQL or advanced Excel to generate reports on system performance, data accuracy, and program utilization for leadership

🎯 Requirements

• Associate of Arts (AA) or Associate of Science (AS) degree (Bachelor’s degree in Health Informatics, IT, or related field preferred) • 5+ years of professional experience in healthcare data analysis, clinical coding, or claims system configuration • Extensive experience with Plexis Quantum Choice (or similar platforms like QNXT) • Strong proficiency in Microsoft Excel (v-lookups, pivot tables) and basic SQL query knowledge • Deep understanding of medical terminology, medical coding (ICD-10/CPT), and reimbursement methodologies (DRGs/HCC) • Knowledge of HIPAA compliance and federal health program standards • Ability to obtain and maintain a Public Trust clearance • Prior experience supporting the World Trade Center Health Program or other federal government health contracts preferred • Professional certification such as CPC (Certified Professional Coder) or CHDA (Certified Health Data Analyst) preferred • Strong analytical mindset with the ability to translate complex clinical rules into technical system requirements

🏖️ Benefits

• 401K with company match • Comprehensive health and wellness packages • Internal mobility team dedicated to helping you own your career • Professional scientific growth opportunities, including journal subscriptions, conference attendance, and supporting publication journey • Cutting-edge technology you can learn from • Rest and recharge with paid vacation and holidays • Paid leave and paid holidays are prorated based on the employee’s date of hire • Eligibility for GDIT Paid Family Leave program, with up to 160 hours of paid leave