Enterprise Medical Policy Coding & Implementation Consultant

Elevance Health; Atlanta (GA); Hybrid; USD 79,000 - 136,000; Full time

Job summary

Elevance Health is seeking an Implement & Coding Consultant to lead the development, implementation, and evaluation of Corporate Medical Policy coding strategies across the enterprise. Hybrid role based in the US with 1-2 in-office days weekly, 8-hour shifts 8:00 am - 5:00 pm EST, Monday to Friday.

Alternate locations considered within commuting distance. The role collaborates with clinical and operations stakeholders, supports policy reviews, and ensures accurate code assignment and QA

Qualifications

• Certified Professional Coder (CPC) strongly preferred.
• Experience reviewing clinical criteria and assigning codes according to coding guidance.

Responsibilities

• Leads development, implementation, and evaluation of medical policy coding strategies.
• Assesses implementation and coding options for policies and recommends optimal approaches.
• Optimizes enterprise solutions for policy implementation balancing clinical, coding, systems, cost, and provider relations.
• Provides coding analysis and responds to coding inquiries for internal partners.
• Maintains QA processes to ensure accurate code assignment and translation within adjudication systems.

Skills

CPC certification

Education

BA/BS degree

Job description

Elevance Health is seeking an Implement & Coding Consultant to lead the development, implementation, and evaluation of Corporate Medical Policy coding strategies across the enterprise. Hybrid role based in the US with 1-2 in-office days weekly, 8-hour shifts 8:00 am - 5:00 pm EST, Monday to Friday.

Alternate locations considered within commuting distance. The role collaborates with clinical and operations stakeholders, supports policy reviews, and ensures accurate code assignment and QA