Payment Integrity Manager, Analytics & Reimbursement

Medica; Hopkins (MN); On-site; USD 79,000 - 135,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Paid time off

Holidays

Volunteer time off

401K contributions

Caregiver services

Job summary

Medica is a nonprofit health plan delivering care across Minnesota and neighboring states. The Manager, Coding leads Payment Analytics and Reimbursement Policy, ensuring accurate provider claim payments and vendor management.

This onsite role involves audits, staff training, and monthly trend reporting to senior leadership. The position focuses on reducing cost leakage, improving pre-payment solutions, and ensuring compliant, auditable processes across departments.

Qualifications

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

Responsibilities

• Develop a forecast of potential savings and oversee monthly savings efforts.
• Recover overpayments identified through retrospective data analytics.
• Communicate team results and drive improvements through trend analysis and automation.
• Educate and advise customers about processes, trends and reimbursement policy.

Skills

Claims & coding experience

People leadership

Data-driven decision making

Analytical thinking

Education

Bachelor's degree or equivalent

Job description

Medica is a nonprofit health plan delivering care across Minnesota and neighboring states. The Manager, Coding leads Payment Analytics and Reimbursement Policy, ensuring accurate provider claim payments and vendor management.

This onsite role involves audits, staff training, and monthly trend reporting to senior leadership. The position focuses on reducing cost leakage, improving pre-payment solutions, and ensuring compliant, auditable processes across departments.