Reimbursement Policy Analyst

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:

• 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
• Coding certification (AAPC or AHIMA) or the completion of such certification within one year of employment is required.
• CPC, CPC-P, CPC-H, CCS, or CCS-P certification preferred
• Knowledge of CPT, HCPCS, and ICD-10 diagnosis codes and coding principles.
• 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.
• HMO and claims experience helpful.

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 Hub role, which requires an employee to occasionally come onsite to the designated office - Minnetonka MN- for applicable heads-up work. Frequency is determined by business need as decided by leadership.

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)