Medical Reimbursement Policy Specialist

1 week ago


Hopkins, Minnesota, United States Medica Full time
Medica Reimbursement Policy Analyst III Job Summary

We are seeking a highly skilled Medical Reimbursement Policy Specialist to join our team at Medica. This critical role requires delivering solidly sourced Payment policy based on recognized industry standard sources, ensuring payment methodologies are defensible and consistent with Medica's Payment philosophy.

About the Role

This position involves serving as a subject matter expert (SME) for reimbursement policies, analyzing and translating data to determine financial impact, and developing recommendations. The ideal candidate will have a strong understanding of coding and reimbursement methodology, as well as excellent communication and presentation skills.

Responsibilities
  • Maintain and implement Medica's Reimbursement Policies, including annual maintenance, research, drafting, and presenting policy recommendations for committee vote.
  • Coordinate claims system changes to support claim payment accuracy.
Requirements
  • Bachelor's degree or equivalent experience in a related field, plus 5 years of work experience beyond degree.
  • Strong computer software skills: Microsoft Office Suite including Access, Excel, PowerPoint, Visio, and Word.
  • Experience leading/facilitating process improvement teams.
What We Offer

In addition to a competitive salary, we offer 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 estimated annual salary range for this position is $72,750 - $129,400, depending on factors such as education, work experience, and internal pay equity.



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