Clinical Policy and Payment Integrity Specialist Position Available In Davidson, Tennessee

Concert is a software and managed services company that promotes health by providing the digital infrastructure for reliable and efficient management of laboratory testing and precision medicine. We are whole-heartedly dedicated to enhancing the transparency and efficiency of health care. Our customers include health plans, provider systems, laboratories, and other important stakeholders. We are a growing organization driven by smart, creative people to help advance precision medicine and health care. Learn more about us at www.concert.co.

YOUR ROLE

Concert is seeking a Clinical Policy and Payment Integrity Specialist to support a portfolio of solutions for transparent coverage and reimbursement of diagnostic procedures. You will be a voice for key clinical data assets within the team. You will be joining an innovative, energetic and passionate team who will help you grow and build skills at the intersection of diagnostics, information technology, and supporting clinical care. After 3 months on the job you will have: Developed an understanding of Concert’s Data Asset and Content Management philosophy, market strategy, information architecture and maintenance cycles Learned to navigate to available content and data assets within the internal Concert Platform and developed an understanding of Concert’s Core Principles Used Concert’s standard operating procedures, templates, and guided approach to evidence interpretation to participate in the content creation process Integrated the company mission and strategy into your contributions to deliverables After 6 months you will have: Participated in all parts of the content innovation and content management work cycles Utilized and supported maintenance of Concert’s claim edit strategies, claims matching system, and taxonomy structure Applied claims analytics to identify new opportunities for the development of coverage criteria and claim edits and independently carried out drafting of new content Used Concert tools to program and maintain content assets within the internal tooling and will have supported the company’s mission of automation After 12 months you will have: Made significant contributions to Concert’s product offerings, workflow strategies, internal process innovations, and maintenance tasks Communicated about claim edit updates and questions within and external to Concert Become a go-to resource within the company for questions about Concert’s medical policy and claim edit development as well as clinical maintenance strategies.

WHAT LEADS TO SUCCESS

Technical Bravery You are comfortable with new technologies and eager to dive in to understand data in raw and in processed states. You like learning about new technologies and diagnostics . Comfort with ambiguity You aren’t afraid of uncertainty and blazing new trails, you care about building towards a future that is different from today. Effective Communication You build rapport and great working relationships with senior leaders, peers, and use the relationships you’ve built to drive the company forward. Executes well You are biased to action and get things done. You acknowledge unknowns and recover from setbacks well. Mission-focused You’re personally motivated to drive more affordable, equitable, and effective integration of diagnostic technologies into clinical care and are coming in with relevant experience aligned with this mission.

RELEVANT SKILLS & EXPERIENCE

Medical policy review and/or writing Reimbursement/administrative policy review Reimbursement/administrative policy writing Revenue Cycle Management Payment Integrity experience (claim edit review, audits, and new edit development) Familiarity with standard coding and reimbursement entities (NCCI, AMA, CMS LCDs/NCDs/B&Rs, etc.)

LOCATION

This company headquarters is in Nashville, Tennessee, however, Concert supports working remotely and is flexible in terms of location in order to find the right candidate. To learn more about the role visit: https://www.concert.co/job-opening-clinical-analyst/.