About this role
General Summary of Duties:
Informing physicians, clinics, hospitals, and other kinds of healthcare organizations via written communication about payers' changes to policies and procedures.Ability to review large quantities of data, to summarize key points, and to classify into relevant categories.Ability to identify medical conditions and coding to ensure the alert created is sent to the correct specialties.Ability to determine the type of alert categories: Administration, Clinical, Pharmaceutical and Reimbursement and select the categories which the alert applies.Reports to the Manager of Payer Alerts
Essential Functions:
Research the internet to locate drugs, conditions and diseases, medical specialties and critical information required to correlate updated health information and the types of providers requiring the information.Classify information into the following categories: Administrative, Clinical, Pharmaceutical, Reimbursement, and Pre-Certification/Authorization.Recognize the various types of web pages (PDF document versus html) and components/functions of a web page (bookmark). 3–5 years of experience in the U.S. healthcare industryBilling or claims experienceKnowledge
Familiarity with ICD-10, CPT, and HCPCS coding standardsUnderstanding of multiple payer types (Commercial, Medicare, Medicaid, and Managed Care)General knowledge of medical specialties, provider types, and care settingsBasic medical terminology knowledgeReview and compare policy updates accuratelyCommitment to collaboration and fostering an inclusive, team-oriented environment Our benefits include: Medical, life and dental insurance, Asociacion Solidarista, International Share Save Plan, Flex Work/Work from home, Paid time off, Annual Performance Bonus, Education Reimbursement, Family Bonding, Bereavement Leave, Referral Program, and more.
At Experian, our people and culture set us apart. We're deeply committed to creating an environment where everyone feels they belong and can excel. From inclusion and authenticity to work/life balance, development, wellness, collaboration, and recognition, we focus on what truly matters. Our people-first approach has earned us global recognition: World's Best Workplaces™ 2024 (Fortune Top 25), Great Place To Work™ 2025 in 26 countries, and Glassdoor Best Places to Work 2024, among others.
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