Client Policy Manager

08 Jan, 2021

Jobs

Client Policy Manager

Cotiviti
Remote/Atlanta, GA

Job Details

Description

The Client Policy Manager provides expert consultation related to medical / payment policy during the planning through operations phases, regarding coding regularity requirements and clinical policy guidelines. This role works with a team of others: Medical Director, Client Managers, and Financial professional to deliver and implement clinical & coding guideline changes to their assigned clients.

Responsibilities:

  • Provides expert consultation during the planning through operations phases, regarding coding regularity requirements and clinical policy guidelines.
  • Function as a key member of the implementation team to collect, collate and articulate the client’s clinical and payment policies.
  • Acts as the key liaison for the clinical information between internal partners and external customers during operations phases.
  • Responds to client inquiries in a timely manner in compliance with policy and procedures.
  • Works collaboratively with the Account Manager and Sales Executive to develop excellent client relationships.
  • Provides clients with high quality and customized analysis of quarterly and ad hoc reports and recommends new reports that would be useful to their clients.
  • Assists the Clinical Content Team with research of new trends and applications for new rules.
  • Provides support to the sales team when presenting clinical information to prospective clients as needed.
  • Provides client support during user acceptance testing.
  • Completes all responsibilities as outlined on annual Performance Plan.
  • Completes all special projects and other duties as assigned.
  • Must be able to perform duties with or without reasonable accommodation

Requirements:

  • Active professional license as a Registered Nurse (BSN preferred) or Bachelor’s Degree in Healthcare related field or equivalent relevant experience.
  • CPC or equivalent certification required.
  • Minimum of 3 years clinical coding experience, preferable in a payer setting.
  • Possesses knowledge of healthcare claims payment policy and processing, specifically, CMS, Medicaid, ICD, CPT, HCPCS and other specialty society, etc.
  • Proficiency in Microsoft Office suite.
  • Familiarity with claims payment and reimbursement methodologies.
  • Ability to analyze complex data and synthesize it for customer and internal consumption.
  • Ability to work well both independently and collaboratively, in a fast-paced and demanding environment.
  • Effective at managing timelines and multiple projects.
  • Effective presentation, verbal and written communication, and interpersonal skills.
  • Ability to travel approximately up to 10% of the time (likely less).

Learn more here

Job posted: 2021-01-08