Manager, Coding — Claims Operations

Job overview

The Manager, Coding — Claims Operations role is an office-based position requiring onsite work an average of three days per week; the listing identifies Madison, WI, among the available office locations. The full salary grade is $78,700–$134,900 per year, with a typical hiring range of $78,700–$118,020; incentive compensation may also be available. Medica is a nonprofit health plan serving members across several states.

What you'll do

• Oversee payment analytics and reimbursement policy work to support appropriate provider claim payment
• forecast potential savings
• oversee analysts’ monthly savings processes
• recover identified overpayments
• investigate root causes and improve claims editing
• develop executive reporting
• monitor financial impact and trends
• ensure auditable processes
• represent the department to stakeholders
• manage, coach, train, and develop staff.

What we're looking for

Skills & competencies

claims operations

coding

payment analytics

reimbursement policy

manager

madison wi

medica

hybrid office schedule

$78,700–$134,900/year

claims auditing

overpayment recovery

team leadership

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, dental, and vision coverage
• paid time off and holidays
• paid volunteer time off
• 401(k) contributions
• caregiver services.

Why this role

Working manager role combining claims audits and analysis with team leadership; onsite an average of three days weekly, with office options also listed in Minnetonka, MN, St. Louis, MO, and Omaha, NE.

About the employer

Medica Services Company LLC is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.