Client Policy Manager
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.
- 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
- 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