Hybrid Manager, Coding & Claims Analytics Leader

Medica; Minnetonka, Omaha, St. Louis (MN, NE, MO); On-site; USD 79,000 - 118,000; Full time

Job summary

Medica, based in Minnetonka, MN, seeks a Manager, Coding (Claims Operations) to lead Payment Analytics and Reimbursement Policy. This onsite role oversees analysts, audits, and cross-functional initiatives in a collaborative healthcare environment.

You will drive pre-payment improvements, monitor savings, recover overpayments, and ensure claim processing accuracy while mentoring staff and coordinating with vendors.

Qualifications

• Bachelor's degree or equivalent experience in related field.
• 7+ years of work experience of progressive experience in claims and coding beyond degree.
• 5+ year of people leadership in healthcare operations.

Responsibilities

• Develop a forecast of potential and error savings goals for analyzing claims data.
• Oversee the day-to-day processes used by analysts to perform monthly savings efforts.
• Recover overpayments identified through retrospective data analytics.
• Uncover root cause of errors, influence stakeholders, sponsor process improvement.
• Develop and maintain relationships with Medica’s claim processing vendor.
• Monitor and report financial impact to management.

Education

Bachelor's degree or equivalent experience in related field

Job description

Medica, based in Minnetonka, MN, seeks a Manager, Coding (Claims Operations) to lead Payment Analytics and Reimbursement Policy. This onsite role oversees analysts, audits, and cross-functional initiatives in a collaborative healthcare environment.

You will drive pre-payment improvements, monitor savings, recover overpayments, and ensure claim processing accuracy while mentoring staff and coordinating with vendors.