ROLE

Proactively participate in regulatory logic compliance and the development of documents, templates and processes utilized for the automation of medical bill review pricing on a national scale. Assist in the implementation of departmental procedures and protocols along with the Regulatory Manager and data team counterparts. Collaborate with the Compliance and Analyst teams to document the development logic needed for the application to access, utilize and successfully adjudicate medical bills in an automated fashion. Develop efficiencies within these processes to assure growth and productivity. Work with the Development team to automate appropriate bill pricing and payment logic.

RESPONSIBILITIES

• Detailed review of regulatory/legislative requirements necessary for bill review automation
• Review converted data and regulations and refine based on application need
• Create and execute state/module specific testing scenarios for pricing and edits logic
• Develop processes for documenting issues encountered and report recommended changes or enhancements to further the automation of accūrō’s proprietary medical bill review pricing application
• Implement automated processes to expedite task completion and increase efficiency
• Perform other duties and assignments as directed by the Regulatory Manager
• Regulatory Analyst JD

QUALIFICATIONS

• 2+ years of data development experience desired
• SQL knowledge and experience required
• MySQL knowledge and experience preferred
• Ability to manipulate MS Excel formulas and queries desired
• Medical Bill Review knowledge and experience preferred
• Ability to work independently and within a coordinated team environment
• Ability to mentor and help train new analysts within the team
• Excellent interpersonal, written, and verbal communication and listening skills

*The responsibilities and duties of this position may be modified from time to time at the discretion of the executive team.

To apply, send resume and cover letter to [email protected].