Remote Clinical Policy & Payment Analyst
Lyric
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Job summary
Lyric is seeking a Clinical Analyst to support the development of clinical policies and payment solutions for fast, accurate coverage and reimbursement decisions. This remote US role requires expertise in diagnostic testing, payment integrity, and clinical care to drive transparency and automation for health plans and labs.
The role focuses on applying claims analytics, literature evaluation, and policy criteria drafting, with opportunities to present to leadership and contribute to AI‑assisted
Qualifications
- Bachelor’s degree in biology, nursing, health sciences, or related field.
- 5 years’ experience in patient care, clinical research, utilization management, payment integrity, revenue cycle management, or related areas.
- Strong software proficiency: MS Word, MS Excel, JIRA or Monday.com.
Responsibilities
- Apply claims analytics to identify coverage criteria opportunities.
- Evaluate medical literature for evidence‑based policy development.
- Draft and maintain coverage criteria by age, presentation, and risk factors.
- Present findings to peers and leadership to gain consensus.
- Program rules for denial of claims based on written policies.
- Enter clinical content into internal tooling and databases.
- Provide clinical content support to customers with Customer Operations.
Skills
Education
Tools
Job description
Lyric is seeking a Clinical Analyst to support the development of clinical policies and payment solutions for fast, accurate coverage and reimbursement decisions. This remote US role requires expertise in diagnostic testing, payment integrity, and clinical care to drive transparency and automation for health plans and labs.
The role focuses on applying claims analytics, literature evaluation, and policy criteria drafting, with opportunities to present to leadership and contribute to AI‑assisted
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