Clinical Consultant I

Overview The Clinical Consultant support Clinical Services teams in the validation of quality and processes consistency on the CPE editing engine. Provides support and subject matter expertise on Coding Validation (CV) to both clients and internal stakeholders during the planning, implementation, go-live, transition to operational team, and through the duration of the contract. Clearly understands and articulates CV concepts and policies. Collaborates with internal teams to provide meaningful input on CV processes, improvements, and support to maximize value and service for clients. Supports internal teams with preparation of new policy presentations and appeals management process. Supports validation of quality and process consistency including customization requests, payment policies, pre and post testing, and UAT testing. Responsibilities Client facing Coding Validation support: Act as a liaison for clinical information between internal partners and external customers. Provide resources to facilitate client understanding of Coding Validation policies and concepts. Respond to client inquiries in a timely manner in compliance with policy and procedures. Review and analyze CV related client inquiries and Change Requests for clarity of intent, assessing impact of decisions for affected policies, and communicating effectively with the client to address questions or clarify information. Provide support and resources to clients for provider abrasion issues. Review and provide wri