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Reimbursement Policy Analyst III

Medica
401(k)
United States, Wisconsin, Madison
1277 Deming Way (Show on map)
Nov 13, 2024
Description

The Reimbursement Policy Analyst serves the critical function of delivering to Medica's customers solidly sourced Payment policy based upon recognized industry standard sources (i.e. CMS, AMA, CPT, national and community payers) to ensure payment methodologies are defensible and consistent with Medica's Payment philosophy.

Responsible for Medica's Reimbursement Policies, including annual maintenance, implementation, research, drafting and presenting policy recommendations for committee vote and coordination of claims system changes to support claim payment accuracy.

Qualifications:



  • Complete working knowledge and skill with ability to be fully proficient in professional field.
  • Bachelor's degree or equivalent experience in related field, plus 5 years of work experience beyond degree.



Skills & Abilities:



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



The full salary range for this position is $60,000 - $102,800. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

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.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
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