Overview
On Site
40 - 45
Contract - W2
Contract - 9 Month(s)
No Travel Required
Able to Provide Sponsorship
Skills
Software engineering
senior software engineer
system design
application development
backend development
data processing
workflow automation
integration development
clinical review systems
cross claim clinical review (CCCR)
retrospective CCV
prepay claim review
outpatient claim review
professional claim review
physician claims processing
hospital claims processing
claims workflow optimization
healthcare revenue cycle
medical claims analysis
cost reduction strategies
revenue acceleration
process improvement
operational efficiency
data‑driven decision making
requirements analysis
stakeholder collaboration
PPM to CV transition
program expansion
innovation in clinical review
retrospective to prepay transformation
cross claim
ppm
Job Details
enior Software Engineers to support CCCR (Cross Claim Clinical Review) as an innovative approach to inpatient clinical reviews, currently available through our Retrospective CCV program. This initiative will extend CCCR to prepay and expand into outpatient and professional claim review as part of PPM to CV. Physician claims are submitted before hospital claims approximately 60% of the time. This enables capturing 60% of retrospective CCCR savings prepayment, accelerating revenue realization and reducing costs. The remaining 40% of savings will continue to be recovered through retrospective CCCR-CCV.
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