Senior Analyst, Edits | Payment Integrity (Remote)
Job Description
Position Description:
CGI is seeking a results-oriented Senior Analyst to join our growing Edits team. In this pivotal role, you will be responsible for expansively growing CGI’s edits library and driving measurable value by identifying and preventing improper payments.
As a Senior Analyst, you will manage the full lifecycle of edit development—from initial opportunity identification to rules design, clinical validation, and deployment. You will serve as a subject matter expert, blending deep coding domain expertise with advanced analytics to ensure payment accuracy and integrity across the healthcare landscape.
Your future duties and responsibilities:
1. Edit Development & Implementation
Identify Opportunities: Use claim data analysis to pinpoint high-impact edit opportunities.
Translate Policy: Convert medical policy, CMS rules, and coding guidance into actionable logic.
Technical Design...