- Implement and measure policies and integrate with all systems to ensure accurate claims processing.
- Assure that changes in policies are communicated to all lines of business.
- Research and apply appropriate and regular updates of CPT, HCPCS, and ICD-9/ICD-10 coding to the policies.
- Prepare final policy documents and tools for implementation.
- Present and provide implementation input to policy committees and meetings.
- Maintain and document system edits, process workflows and process documentation.
- Maintain Blue Cross external and internal policy databases with current policy decisions and coding.
- Produce standard reports and assist in the analysis and impact of these reports as they relate to reimbursement policy implementation process.
- Serve as a subject matter expert to team members and workgroups.
- Support the reimbursement policy team to solution for reimbursement policy issues and overall policy strategy as needed.
- 6+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
- Ability to apply critical thinking skills to policy interpretation and implementation.
- Ability to work independently; well-organized and able to set priorities with minimal direction.
- Ability to effectively communicate both verbally and in writing.
- Strong PC skills, including Excel, PowerPoint, Visio, Word, and internet-based programs.
- Ability to develop and work on several projects at one time in a fast-paced environment.
- Ability to build and maintain relationships with internal and external stakeholders, clinicians, and others.
- Project management experience.
- Demonstrated positive professionalism in all work-related behaviors as demonstrated by adaptability, contributing to team success, customer focus, skillful communication, and efficiently managing work.
- Strong documentation and workflow process skills.
- Experience with measuring and monitoring plans.
- Bachelor's and/or master's degree in a clinical or health-related field with 6 years' experience working in a health care environment.
- End to end claims process experience.
-
Implementation Consultant
2 days ago
Thomson Reuters Eagan, United StatesImplementation Consultant · Are you a seasoned professional in technical, customer-facing consulting? Join the Thomson Reuters team and specialize in delivering market-leading legal software, HighQ. · About the Role · In this opportunity as Implementation Consultant, you will: ...
-
Implementation Consultant
3 weeks ago
Thomson Reuters Eagan, United States Regular, Full timeAre you a seasoned professional in technical, customer-facing consulting? Join the Thomson Reuters team and specialize in delivering market-leading legal software, HighQ. · About the Role · In this opportunity as Implementation Consultant, you will: · Scope Project Requirements: ...
-
Blue Cross Blue Shield of Minnesota Eagan, United StatesAbout Blue Cross · Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us. ...
-
Implementation Consultant
6 days ago
MatrixCare Minneapolis, United StatesResMed has always applied the best of technology to improve people's lives. Now our SaaS technology is fueling a new era in the healthcare industry, with dynamic systems that change the way people receive care in settings outside of the hospital-and tools that work every day to h ...
-
Implementation Consultant
6 days ago
Sovos Compliance Hopkins, United StatesBuild your future with Sovos. · If you're seeking a career where innovation meets impact, you've come to the right place. As a global leader, Sovos is transforming tax compliance from a business requirement to a force for growth while revolutionizing how businesses navigate the ...
-
Implementation Consultant
5 days ago
Hirebridge Hopkins, United StatesIf you're seeking a career where innovation meets impact, you've come to the right place. As a global leader, Sovos is transforming tax compliance from a business requirement to a force for growth while revolutionizing how businesses navigate the ever-changing regulatory landscap ...
-
Blue Cross Blue Shield of Minnesota Eagan, United StatesAbout Blue Cross · Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us. ...
-
Implementation Consultant
2 weeks ago
MatrixCare Minneapolis, United StatesResMed has always applied the best of technology to improve people's lives. Now our SaaS technology is fueling a new era in the healthcare industry, with dynamic systems that change the way people receive care in settings outside of the hospital-and tools that work every day to h ...
-
Implementation Consultant
3 weeks ago
goVirtualOffice LLC Minneapolis, United StatesJob Description · Job Description · Picture yourself building a successful career at a company that has been awarded "Madison Best Places to Work". Thrive alongside other talented, driven individuals to help fast growing organizations and mid-size companies enhance productivity ...
-
Implementation Consultant
3 weeks ago
goVirtualOffice, LLC Minneapolis, United StatesJob Description · Job DescriptionPicture yourself building a successful career at a company that has been awarded "Madison Best Places to Work". Thrive alongside other talented, driven individuals to help fast growing organizations and mid-size companies enhance productivity, imp ...
-
Blue Cross and Blue Shield of Minnesota Eagan, United States Full timeAbout Blue Cross · Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us. · ...
-
BlueCross BlueShield of Minnesota Eagan, United States Regular, Full timeAbout Blue Cross · Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us. · ...
-
Implementation Consultant
2 weeks ago
Granicus Saint Paul, United States Regular, Full timeThe Company · Serving the People Who Serve the People · Granicus is driven by the excitement of building, implementing, and maintaining technology that is transforming the Govtech industry by bringing governments and its constituents together. We are on a mission to support our ...
-
System Integration Implementation Consultant
1 week ago
Public Consulting Group Minneapolis, United StatesOverview · About Public Consulting Group · Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs appr ...
-
Software Implementation Consultant, Clinical
1 week ago
PointClickCare Bloomington, United States Full timePosition SummaryAs part of the Professional Services, Solution Services team, the Software Implementation Consultant, will act as the principal liaison with the customer to implement leading practices to optimize workflows and drive business outcomes within the Long-Term and Post ...
-
Dayforce Payroll Implementation Consultant
3 weeks ago
Spencer Thomas Group Minneapolis, United StatesPosition Overview: · Spencer Thomas Group (STG) is currently looking to add to our team of consultants under our Dayforce Payroll/HCM Practice. · Our client is looking for internal support to lead their projects from experienced professionals who understand their system at a mod ...
-
Dayforce Payroll Implementation Consultant
3 weeks ago
Spencer Thomas Group Minneapolis, United StatesPosition Overview:Spencer Thomas Group (STG) is currently looking to add to our team of consultants under our Dayforce Payroll/HCM Practice. · Our client is looking for internal support to lead their projects from experienced professionals who understand their system at a module ...
-
Sr. Acumatica Implementation Consultant
2 weeks ago
CliftonLarsonAllen Minneapolis, United StatesCLA is a top 10 national professional services firm where · our purpose is to create opportunities · every day, for our clients, our people, and our communities through industry-focused wealth advisory, digital, audit, tax, consulting, and outsourcing services. Even with more t ...
-
FusionWorks Como, United StatesSenior Atlassian Consultant (w/d/m) · Germany - 100% Remote · B2 + German language proficiency required · Company: · Join one of the leading Atlassian Platinum Solution Partners in Germany. With a highly knowledgeable team of over 80 Atlassian experts, they pride themselves on de ...
-
Sr. Acumatica Implementation Consultant
3 weeks ago
CliftonLarsonAllen Minneapolis, United States Regular, Full timeCLA is a top 10 national professional services firm where our purpose is to create opportunities every day, for our clients, our people, and our communities through industry-focused wealth advisory, digital, audit, tax, consulting, and outsourcing services. Even with more than 8, ...
Senior Policy Reimbursement Implementation Consultant - Eagan, United States - Blue Cross and Blue Shield of Minnesota
Description
About Blue Cross
Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us.
How Is This Role Important to Our Work?
This position is responsible for ensuring that reimbursement policies are implemented and integrated with all systems to ensure accurate claims' processing. This will include reviewing and applying new codes to the reimbursement policies, developing quality improvement processes for policy implementation, and assisting with data reporting needs, as they pertain to the reimbursement policy decision making process. Additionally, this role will organize communication of reimbursement policy changes and issues. This position will also serve as a support resource within the division and within the reimbursement policy team.
A Day in the Life:
Required Skills and Experiences:
Nice to Have:
Role Designation:
TeleworkerRole designation definition: Teleworking is working full time remote. Hybrid is a combination of working onsite and remotely. Onsite is full-time onsite.
Make a difference
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
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.
