Clinical Policy & Payments Analyst (Remote - US)

Lyric; Phoenix (AZ); Remote; USD 85,000 - 120,000; Full time

Job summary

Lyric is seeking a Clinical Analyst to support development of clinical policies and payment solutions that enable fast, accurate coverage decisions. You will influence clinical content and data assets, driving transparency and automation across real-time claims workflows.

The role requires a deep understanding of diagnostic testing, IT, payment integrity, and clinical care, with remote-US flexibility for a full-time position. Strong communication and analytic skills are essential.

Qualifications

• Bachelor’s degree in biology, nursing, health sciences, or related field.
• 5 years’ experience in direct patient care, clinical research, utilization management, payment integrity, revenue cycle management, clinical product development/program management, market access/medical science liaison, or medical writing.
• Excellent communication skills (verbal and written) enabling effective communication internally and externally.

Responsibilities

• Apply claims analytics to identify opportunities for coverage criteria and claim edit development.
• Identify and evaluate medical literature as part of evidence-based policy development.
• Draft, review, and maintain coverage criteria based on age, clinical presentation, and risk factors.
• Provide written and oral presentations to peers and leadership to obtain consensus on proposed criteria.
• Recommend and program rules/logic for denial of claims based on written policies.
• Enter clinical content into internal tooling and databases.
• Provide clinical content support to customers in collaboration with Customer Operations as needed.

Skills

Clinical Experience

Data Analysis

Excel Proficiency

Verbal & Written Communication

PM Software

Education

Bachelor’s degree in biology, nursing, health sciences, or related field

Tools

JIRA

MS Word

MS Excel

Monday.com

Job description

Lyric is seeking a Clinical Analyst to support development of clinical policies and payment solutions that enable fast, accurate coverage decisions. You will influence clinical content and data assets, driving transparency and automation across real-time claims workflows.

The role requires a deep understanding of diagnostic testing, IT, payment integrity, and clinical care, with remote-US flexibility for a full-time position. Strong communication and analytic skills are essential.