Senior Managed Care Policy Analyst - Remote

Overview

The Senior Managed Care Policy Analyst will manage the representation of medical rules and support clients with technical issues, while also engaging in coding and data management related to healthcare policies.

In Short

• Manage medical rules and edits from various sources.
• Build tables and assist clients with technical support issues.
• Review and recommend coding and logic placements.
• Prepare reports and documents for compliance review.
• Analyze data for coding trends and documentation requirements.
• Maintain medical rules in the appropriate database.
• Conduct independent reviews of coding issues.
• Stay updated on current coding issues and guidelines.
• Collaborate with clients on coding and policy matters.
• Ensure integrity checks on data tables.

Requirements

• Associate's or Bachelor's degree in Life Sciences or relevant certification.
• 4+ years of experience with CPT and ICD-10 coding.
• Experience in researching medical edits.
• Knowledge of Medicare reimbursement guidelines.
• Strong understanding of medical terminology and anatomy.
• Excellent communication skills.
• Ability to write clearly and effectively.
• Previous experience in healthcare is preferred.

Benefits

• Competitive compensation package and bonus plan.
• Core benefits including medical, dental, and vision.
• Flexible work environment with remote options.
• Flexible time off including vacation and sick leave.
• Opportunities for personal and professional development.