Reimbursement Policy Analyst III

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

Certifications and Licensures

• Coding certification strongly preferred ex. CPC, CPC-P, COC, RHIT, CCS (preferred someone credentialed in facility coding)

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

This position is a Remote role and will work remotely 100% of the time. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.

The full salary range for this position is $61,500-$105,400. 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.

We are an Equal Opportunity 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.