Medical Policy & Coding Support Coordinator, CPC/CPC-A Preferred

🔥 2 hours ago

🌾 Iowa – Remote

🌾 Iowa – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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Wellmark Blue Cross and Blue Shield

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1939

⚕️ Healthcare Insurance

Healthcare Insurance

Wellmark Blue Cross and Blue Shield is a health insurance provider operating primarily in Iowa and South Dakota. The company offers a range of health insurance plans including individual and family plans, Medicare Advantage, Medicare Supplement, and employer group plans. Wellmark emphasizes providing coverage options that meet diverse needs and budgets, and offers resources for managing accounts, payments, and health care access through their online portal, myWellmark. Additionally, Wellmark provides resources for providers, employers, and producers to drive business efficiency and quality in health care services.

📋 Description

• Support Medical Policy Team’s operations • Create and manage monthly Medical Policy production timelines • Maintain Medical Policy material distribution lists • Verify that the monthly authorization table updates align with quality expectations • Support virtual Medical Policy Committee (MPC) operations • Partner with the coding specialist role in support of the Medical Policy Implementation Committee (MPIT) • Support Medical Policy leadership in initial research on impact of changes in vendor and BCBSA Reference Medical Policy changes • Monitor and triage Medical Policy inbox for external inquiries • Perform monthly medical policy coding analyses and SAP BusinessObjects reports • Ensure that all documentation related to health policy decisions is complete and accurate • Update system configurations for accurate administration of health policies • Participate in cross-functional meetings or initiatives to support the enterprise strategic priorities

🎯 Requirements

• High school diploma or GED • Certified Professional Coder (CPC) required • 4+ years of experience in provider payment, claims or medical coding • Coding knowledge – e.g. ICD-10, HCPC, CPT • Strong customer service and communication skills • Strong organizational and project management skills • Administrative task skills such as filing external appeals • Strong critical thinking and decision-making skills • Proficient with MS Office • Associate's or bachelor's degree in a relevant field (e.g., health administration, business administration, or a related discipline) (preferred) • Claims experience with knowledge of Facets (preferred) • Familiarity with SAP BusinessObjects (preferred)

🏖️ Benefits

• Health insurance • Flexible work arrangements • Professional development opportunities