Support the Medical Policy Team by providing medical coding, system configuration, administrative, and operational assistance.
- Perform coding analyses and utilization reporting to identify needed updates to medical policies and system configuration.
- Support monthly and quarterly Medical Policy production timelines and external appeals processing.
- Assist with Medical Policy Committee and Medical Policy Implementation Committee activities, including meeting support, agenda preparation, minutes, and follow-up documentation.
- Research the impact of vendor and reference medical policy changes and support new policy development.
- Monitor Medical Policy inboxes, create internal forms, and help ensure documentation is accurate, complete, and timely.
- Update system configurations and support claim system edits, testing, documentation, and audit readiness.
- Participate in cross-functional meetings and initiatives aligned to enterprise priorities.
Requirements & Qualifications
- High school diploma or GED required.
- Certified Professional Coder (CPC) required; must obtain within 12 months of hire and maintain throughout employment.
- 4+ years of experience in provider payment, claims, or medical coding.
- Knowledge of ICD-10, HCPCS, and CPT coding.
- Strong communication, customer service, critical thinking, and decision-making skills.
- Excellent organizational, project management, and workflow management abilities.
- Ability to manage administrative tasks, including filing external appeals.
- Detail-oriented with a strong commitment to accuracy, quality, timeliness, and production metrics.
- Proficiency with MS Office.
- Preferred: associate's or bachelor's degree, Facets experience, SAP BusinessObjects familiarity, and auditing experience.
Location
Iowa, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
2 weeks ago