Manager, Coding & Claims Analytics

Medica; Madison (WI); On-site; USD 79,000 - 118,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Paid time off & Holidays

401K contributions

Job summary

Medica is seeking a Manager, Coding to lead Payment Analytics and Reimbursement Policy. This onsite role supports claims accuracy, vendor collaboration, and cost containment, with visibility to senior leadership through monthly trend reporting.

The position requires a Bachelor’s degree and 7+ years in claims/coding plus 5+ years in healthcare leadership. Office-based with in-person collaboration at multiple Midwest locations, including Madison, WI.

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 and monitor goals and metrics for analytic identification and reimbursement policy effectiveness.
• Oversee monthly savings efforts and ensure accurate claims payment processing.
• Report overpayments or suspected fraudulent behavior to SIU and manage notifications to leadership.
• Lead department production goals and ensure completion of performance reviews and coaching.
• Collaborate with stakeholders across Medica to ensure policy compliance and effective vendor relations.
• Develop and maintain auditable processes and monthly/quarterly trend analyses.

Skills

Strategic thinking

Analytical skills

Cross-functional collaboration

Data-driven decision making

Education

Bachelor’s degree or equivalent

Job description

Medica is seeking a Manager, Coding to lead Payment Analytics and Reimbursement Policy. This onsite role supports claims accuracy, vendor collaboration, and cost containment, with visibility to senior leadership through monthly trend reporting.

The position requires a Bachelor’s degree and 7+ years in claims/coding plus 5+ years in healthcare leadership. Office-based with in-person collaboration at multiple Midwest locations, including Madison, WI.