Reimbursement Policy Analyst Jobs

The Reimbursement Policy Analyst is responsible for the overall strategic process related to identifying, developing, implementing and supporting Medica’s provider reimbursement policies. The Reimbursement Policy Manager performs critical functions to manage the end-to-end policy process which include: research, data analysis, policy development, annual maintenance, implementation, communication, training, and issue resolution.
Qualifications:

• Coding certification (AAPC or AHIMA) or the completion of such certification within one year of employment is required.
• Knowledge of CPT, HCPCS, and ICD-10 diagnosis codes and coding principles.
• HMO and claims experience helpful.
• Bachelor's degree or equivalent experience in related field, plus 5 years of work experience beyond degree
• Advanced working knowledge and skill in this professional field with ability to function as a subject matter expert for other staff
• CPC, CPC-P, CPC-H, CCS, or CCS-P certification preferred
• Experience with hospital/facilities coding (UB-04), revenue codes, DRGs, APCs and ICD-10 diagnosis and procedural codes desirable; those having at least one of the 3-5 years of experience in both professional and facilities coding is a plus.

Skills & Abilities:

• Ability to prepare and develop and diverse information into effective presentations
• Able to analyze and translate data (to determine financial impact) and develop recommendations
• Strong computer software skills: Microsoft Office Suite including Access, Excel, PowerPoint, Visio, and Word
• Experience leading/facilitating process improvement teams
• Strong understanding and knowledge of coding and reimbursement methodology
• Function as a SME for reimbursement policies

This position is a Remote role. The employee must be located in any state in which Medica is an employer and will work remotely 100% of the time.
Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.