Job Description

About Blue Cross and Blue Shield of Minnesota


At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming health care. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

How Is This Role Important to Our Work?

The incumbent will collect and analyze data related to healthcare medical coding and reimbursement policies to provide recommendations to leadership to reflect changing trends, emerging technologies and other regulatory developed program needs. Serves as a primary contact with business leadership and is accountable for directing projects and coordinating related activities (internal and external) of medical coding projects.

A Day in the Life:

• Conduct in-depth research and analysis of appeals data and processes to identify trends and emerging issues, and recommend best practices for maximum performance.
• Provide recommendations to leadership to modify reimbursement policies aligning with changing trends, emerging technologies, and other regulatory developed programs related to healthcare reform.
• Lead communication of changes in company coding and reimbursement policies to all lines of business, internal business teams and contracted providers.
• Serve on external committees representing the company's position on Medical Coding requirements.
• Bring information learned through those committees back to the company's project teams and identify crucial issues impacting those teams.
• Serve as a subject matter expert to other divisions/departments (Health Services, Service, Claims) for coding policy and coding/payment issues.
• Directs and coordinates activities of designated coding projects through the project life cycle including the needs assessment, project initiation, design, development and implementation.
• Research and communicate/implement resolutions related to coding appeals assuring that federally and state mandated coding rules are followed.
• Directs and coordinates activities of cross-departmental committees (e.g. Coding and Reimbursement, RICHIE, NAG, I-team).
• Assumes mentor and role model responsibilities across all Provider Finance and Administrative Simplification functions.

Nice to Have:

• Bachelor's degree.
• Enhanced knowledge of STAR, PAandR, IMS or other internal systems.

Required Skills and Experiences:

• 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• At least 2 of the following certifications: CPC, CPC-H or CPC-P.
• Incumbent is expected to enroll in continuing education courses to maintain certification.
• Demonstrated ability to apply critical thinking skills to coding policy interpretation and implementation.
• Ability to work independently, self-directed and with team members.
• Ability to lead team members to resolve complex issues and mentor others on the team.
• Strong PC skills; Excel, Word, PowerPoint and internet based programs.
• Ability to maintain relationships with internal and external stakeholders, coding experts, and others.

Compensation and Benefits:

Pay Range: $77,200.00 - $102,300.00 - $127,400.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement


Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.


Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.


All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.


Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Job Tags

Full time,

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