Job Description

As a Healthcare Content Portfolio Analyst, you'll translate complex healthcare policies into automated logic for Rialtic's payment accuracy engine. You'll develop claims editing rules, validate logic, and act as a subject matter expert on Medicaid, Medicare, and commercial lines. The role requires high autonomy, collaboration, and a desire to deepen technical expertise while shaping a modern healthcare platform.

Responsibilities

• Interpret and translate complex healthcare policies into actionable claims editing logic.
• Develop precise, high-quality edit specifications.
• Design and execute robust unit tests to validate logic.
• Act as a subject matter expert across Medicaid, Medicare, and commercial lines.
• Maintain and enhance existing content by monitoring and applying policy updates.
• Analyze performance data and document rationale and results.
• Collaborate with Product and Engineering to improve tooling and workflows.
• Independently manage the end-to-end lifecycle of content edits.
• Stay current on evolving healthcare regulations and coding guidelines.
• Exceed productivity and quality targets.

Requirements

• Bachelor's degree preferred in Healthcare, Technology, or related field.
• 8+ years of experience in healthcare coding, billing, or payment accuracy.
• National coding credential (CPC, CCS-P, RHIA, CCS, CPB or equivalent).
• Deep familiarity with CMS policies (LCAs, LCDs, NCDs), CCI edits, OIG alerts, fee schedules.
• Strong understanding of claims processing workflows (CMS-1500, UB-04).
• Prior experience developing or managing claims edits.
• Comfortable collaborating with engineering and product.
• Intermediate Excel skills (pivot tables, VLOOKUP, functions).

Benefits

• No benefits