Secondary Editing

Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.

**Overview ClaimsXten**:
TPG Capital recently completed the purchase of Change Healthcare’s Clinical Claims Management (CCM) business, which includes the ClaimsXten®, ClaimsXten® Select, ClaimCheck, Secondary Editing, and Episode Manager solutions. The transaction establishes the CCM business as an independent company, with an interim name of ClaimsXten Portfolio. ClaimsXten Portfolio has a long history as a trusted partner and market leader in primary claim editing, delivering value through savings, operational efficiencies, and long-standing partner relationships.

TPG Capital is a leading private equity platform of alternative asset management firm TPG and an active, experienced healthcare and software investor. TPG has a long history of partnering with companies, including the ClaimsXten Portfolio Business-a trusted partner and market leader in primary claim editing, delivering value through savings, operational efficiencies, and long-standing partner relationships. ClaimsXten’s primary solutions are ClaimsXten®, ClaimsXten® Select, ClaimCheck, Secondary Editing, and Episode Manager.

**Work Location**:

- Fully Remote - U.S.

**Position**:
The Secondary Editing PAA functions as a Subject Matter Expert (SME) for implementing and maintaining the ClaimsXten (CXT) Rules and Rule Logic in partnership with customer’s deployment of the ClaimsXten Cloud Services program. The specialist will do this by engaging with assigned customers as a CXT SME to understand their claim system(s), payment policies, and integration data elements managed thru the use of CXT for total payment accuracy.

**Core Responsibilities**:

- Opportunity Evaluation, Analysis and Data Mining
- New Opportunity Vetting with Customer
- Deployment Planning
- New Opportunity Implementation
- Monitoring and Measuring
- Minimum of 4 years of experience in health care (claims, coding, requirements gathering, and/or consulting)
- Software Development Life Cycle (SDLC) exposure
- Minimum of 2 years experience with presenting content (presentations/projects/etc ) to internal and/or external clients
- Minimum of 2 years experience working with payor/vendor environments and claims management
- Bachelor’s Degree in computer science, healthcare related field, or equivalent business experience

**Preferred Qualifications**:

- High level of expertise in payor environments and claims management
- Granular understanding of different customer segments (national, strategic and/or specialized business)
- High level of understanding of medical terminology, healthcare industry terminology and medical coding terminology
- Experience driving content updates either at a Health Plan or Clinical Code Editing Vendor
- Certified Coder Experience

**Working Conditions/Physical Requirements**:

- General office demands

**Travel**: _If the position does not require travel, remove this section._
- Up to15%
- Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.

**Diversity and Inclusion**:

- At ClaimsXten Portfolio, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.

This would be where the updated NY and NJ compensation verbiage goes as well.

li-remote

**Colorado Residents Only**:
**Diversity, Equity & Inclusion***:

- At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.

**COVID Vaccination Requirements**

**Equal Opportunity/Affirmative Action Statement***

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.