Medical Content Analyst - Content Innovation

Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI.

JOB SUMMARY

The Medical Content Analyst will independently research and identify new clinical content areas of claims editing, by reviewing specialty societies, peer reviewed medical journals, etc., to recommend new savings opportunities for Lyric customers.

ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES

• Evaluate analytics reports and medical claims to identify new claims editing opportunities
• Contribute to the content topics backlog for editing consideration
• Function as a subject matter expert for current claims audition and medical coding scenarios to expand editing outcomes
• Provide content knowledge transfer to colleagues for rule development
• Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion with Lyric business rules
• Responsible for making recommendations within the software for the denial of diagnosis, age, or other criteria on medical claims based on coding guidelines
  
  

• BS Nursing, BS Pharmacy or equivalent required
• 4 years’ experience in medical billing, coding, claims processing, bill and/or chart review/auditing, is required. Previous experience working with US health insurance payers in a claims, appeals or coding capacity is also required
• Experience in denial management or claim review management is a plus
• Excellent communication skills (verbal and written) enabling effective communication both internally with all areas of the business and externally
• Demonstrated proficiency with various software applications, including but not limited to: MS Word; MS Excel; MS Access; Visio; JIRA; SharePoint with MS project a plus
• AHIMA Certified Coding Specialist – Physician (CCS-P) or AAPC Certified Professional Coder (CPC) is required
  
  

• Ability to influence and direct thoughts and actions to successfully reach goals
• Embraces challenges, persists in the face of setbacks and finds inspiration in the success of others
• Proven ability to engender client trust and build relationships through partnering with clients for innovation and providing high quality products and services
• Can provide clear, balanced advice/counsel on a range of strategic and complex management, product and market issues
• Results-oriented style with a high degree of analytical ability and proven problem-solving skills
• Ability to thrive and quickly adapt to change, leading others through change in a dynamic, fast-paced industry and work environment
• Ability to manage a team in a matrix environment to recruit and retain top talent, build consensus, and rally members to achieve results
• Effectively builds strong relationships and partnerships within and outside of the company. Able to effectively navigate within a matrixed corporate structure
• With an open, honest and direct communication style that establishes an empathetic and effective relationship