How Is This Role Important to Our Work?

The incumbent is responsible for ensuring reimbursement policies, including the medical coding they might contain, are researched, developed, and maintained to accurately reflect BCBSMN's position on the topics they address. This role will serve as the subject matter expert for internal and external inquiries related to the policies.

A Day in the Life:

• Manage the annual policy review process. This includes collaborating with colleagues at BCBSMN, and the Association to ensure the policies remain current in coding and content and align with the market.
• Maintain vigilance of local and national policy trends and be able to translate how that might be optimally applied to BCBSMN's business.
• Maintain current knowledge of coding trends and changes and be able to apply that knowledge appropriately to BCBSMN's policies. This includes the ability to identify situations in which a new policy may be needed.
• Clearly and concisely present new and revised policies at meetings to ensure all in attendance understand the content and can comment or vote in a well-informed manner.
• Monitor and track Reimbursement Policy BEM questions/inquiries from organizational partners.
• Participate as the subject matter expert in special projects and assignments within specific time frames.
• Ensure policies are accurate before being posted to internal and external websites and applications.
• Assist in maintaining policy tracking and status during implementation.
• Assist with Reimbursement policy database updates and changes.
• Serve as a liaison to other divisions/departments (Health Management, Service, Claims) for Reimbursement Policy.
• Participate as a team member of cross-departmental committees (e.g., BCAG, etc).

Required Skills and Experiences:

• Associate degree in business, health care or related field or 2 years of related experience in lieu of a degree.
• Deep knowledge of medical terminology, and/or coding certification.
• Strong PC skills; Excel, Word, PowerPoint, and internet-based programs.
• Ability to manage key details and keep areas of accountability organized.
• Strong interpersonal, presentation, written, and verbal communication skills.
• Ability to apply critical thinking skills to Reimbursement Policy interpretation and implementation.
• Ability to work independently; well-organized and able to set priorities with minimal direction.

Nice to Have:

• Bachelors' Degree in business or related field.
• 5 years of experience in a health care setting.
• Analytical skills