Medical Codebook Analyst – Plexis Quantum Choice

Emploi pas sur LinkedIn

🕒 il y a 1 mois

🇺🇸 États-Unis – Télétravail

💵 $48 450 - $65 550 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

🧐 Analyste

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General Dynamics Information Technology

Site WebLinkedInTous les Emplois

10 000+ employés

Fondée en 1954

🔒 Cybersecurity

🤖 Intelligence artificielle

Defense • Cybersecurity • Artificial Intelligence

General Dynamics Information Technology (GDIT) est un acteur de premier plan de l’innovation technologique, offrant un large éventail de services, notamment le conseil, la modernisation numérique et les services applicatifs. L’entreprise déploie des solutions en intelligence artificielle (AI), cloud computing (Cloud), cybersécurité, calcul haute performance (HPC) et technologies quantiques. GDIT s’engage à soutenir les secteurs public et de la défense, en fournissant des services essentiels à la mission tels que la logistique et la gestion de la chaîne d’approvisionnement, le renseignement et la sécurité intérieure. L’entreprise met également l’accent sur des pratiques de recrutement diversifiées et inclusives et promeut activement le bien-être des collaborateurs. Grâce à ses accélérateurs numériques et à l’adoption pionnière de technologies émergentes, GDIT vise à faire progresser les missions des agences et à relever des défis technologiques complexes.

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

🎯 Exigences

• 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

🏖️ Avantages

• 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