Lyric - Clarity in motion. Logo

Lyric - Clarity in motion.

Claims Requirements Analyst

Job Posted 12 Days Ago Reposted 12 Days Ago
Remote
Hiring Remotely in United States
85K-128K Annually
Senior level
Remote
Hiring Remotely in United States
85K-128K Annually
Senior level
The Claims System Analyst will translate clinical requirements into functional documentation, collaborate with teams, conduct UAT, and support policy documentation to ensure payment accuracy.
The summary above was generated by AI

Lyric, formerly ClaimsXten, is a leading healthcare technology company, committed to simplifying the business of care. Over 30 years of experience, dedicated teams, and top technology help deliver more than $14 billion of annual savings to our many loyal and valued customers—including 9 of the top 10 payers across the country. Lyric’s solutions leverage the power of machine learning, AI, and predictive analytics to empower health plan payers with pathways to increased accuracy and efficiency, while maximizing value and savings. Lyric’s strong relationships as a trusted ally to customers resulted in recognition from KLAS as “true partner” and “excellent value for investment,” with a top score for overall customer satisfaction and A+ likelihood to recommend in their October 2023 Payment Integrity and Accuracy Report. Discover more at Lyric.ai. 

Applicants must already be legally authorized to work in the U.S.  Visa sponsorship/sponsorship assumption and other immigration support are not available for this position.

The Claims System Analyst is integral to the success of the policy and business development process at Lyric. This role is responsible for translating the clinical requirements into functional requirements and the creation of policy and rule specifications, incorporating best design practices. This role is vital to the expansion and effectiveness of our ClaimsXten editing packages and helps promote payment accuracy. Your workday will be self-directed and collaborative with cross functional teams, where clear communication will be vital to success.

 

Role Responsibilities:

  • Translate clinical requirements into functional design documentation, incorporating best practices and clinical development protocols for ClaimsXten.

  • Collaborate with Requirements team and cross-functional team members, to evaluate rule/policy behavior and to confirm that solution requirements meet business expectations and align with client implementation standards.

  • Support the documentation of content requirements to promote immediate post release content maintenance handoffs.

  • Serve as a contributor to all user documentation (edit clarifications, Rules Guide, etc.,)

  • Assist with all end-user training activities.

  • Peer review and contribute to Quality Assurance test plan validation, unit test reviews, and functional testing.

  • Perform user acceptance testing (UAT) of policies and/or rules.

  • Provide policy and rule logic subject matter expertise to internal and external clients

Basic Requirements:

  • Education: Bachelor’s degree in a Computer/Information Systems or Healthcare related field required.

  • 5+ years relevant experience as a Systems or Claims Analyst in a Healthcare organization required.

  • 5+ years experience writing to write document flow statements in Visio or similar program

  • 5+ years of demonstrated technical awareness regarding clinical development solutions, and understanding of the software development lifecycle

Preferred Qualifications:

  • Previous experience supporting ClaimsXten is strongly preferred.

  • Master’s degree in computer/information systems or healthcare related field.

  • Knowledge of healthcare reimbursement and payment policies and methodologies.

  • Working knowledge of pre-payment editing and payment integrity is preferred.

  • Previous healthcare related experience in a technology role is a plus.

  • Strong communication skills: Must be an expert at presenting extraordinarily complex material via all mediums.

  • Analytical skills: Candidate must possess the ability to analyze complex data and assess potential vulnerabilities.

  • Superior critical thinking skills

  • Proficiency in Microsoft applications.


***The US base salary range for this full-time position is:

$85,018.00 - $127,526.00

The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation. ***

Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success.

Top Skills

Microsoft Applications
Visio

Similar Jobs

3 Hours Ago
Remote
United States
Senior level
Senior level
Professional Services • Security • Consulting • Cybersecurity • Generative AI • Data Privacy
The Demand Generation Senior Manager leads demand generation strategies, executes campaigns, manages budget proposals, and collaborates with teams to drive client acquisition in B2B tech and cybersecurity sectors.
Top Skills: Account-Based MarketingContent SyndicationDigital MarketingEmail MarketingMarketing AutomationSeo
3 Hours Ago
Easy Apply
Remote or Hybrid
Chicago, IL, USA
Easy Apply
137K-154K Annually
Mid level
137K-154K Annually
Mid level
Artificial Intelligence • Cloud • Information Technology • Machine Learning • Software
The Channel Account Manager drives channel business growth, collaborates with teams, manages partner relationships, and provides sales forecasts to exceed quotas.
Top Skills: AIMachine LearningObservability
3 Hours Ago
Easy Apply
Remote
United States
Easy Apply
176K-272K
Senior level
176K-272K
Senior level
Security • Software • Cybersecurity • Automation
The Director, Technical & Value Strategist will lead strategic technical engagement and business value assessments, focus on AI tool adoption, and facilitate high-impact POCs.
Top Skills: Ai ToolsGovernanceRisk And Compliance (Grc)Saas Platforms

What you need to know about the Seattle Tech Scene

Home to tech titans like Microsoft and Amazon, Seattle punches far above its weight in innovation. But its surrounding mountains, sprinkled with world-famous hiking trails and climbing routes, make the city a destination for outdoorsy types as well. Established as a logging town before shifting to shipbuilding and logistics, the Emerald City is now known for its contributions to aerospace, software, biotech and cloud computing. And its status as a thriving tech ecosystem is attracting out-of-town companies looking to establish new tech and engineering hubs.

Key Facts About Seattle Tech

  • Number of Tech Workers: 287,000; 13% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Amazon, Microsoft, Meta, Google
  • Key Industries: Artificial intelligence, cloud computing, software, biotechnology, game development
  • Funding Landscape: $3.1 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Madrona, Fuse, Tola, Maveron
  • Research Centers and Universities: University of Washington, Seattle University, Seattle Pacific University, Allen Institute for Brain Science, Bill & Melinda Gates Foundation, Seattle Children’s Research Institute
By clicking Apply you agree to share your profile information with the hiring company.

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account