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Provider Reimbursement Manager – Behavior Health, Coding
Elevance HealthProvider Reimbursement Manager responsible for behavioral health reimbursement policy at Elevance Health. Leading policy development and data analysis to improve cost of care initiatives.
About the role
Key responsibilities & impact- Manage key components of the provider reimbursement strategy and policy
- Ensure accurate adjudication of claims
- Translate various complex coding, business and billing rules into effective reimbursement policies
- Serve as subject matter expert regarding reimbursement policies, edits, behavioral health standards, billing, and coding conventions
- Lead policy development for specific plans
- Work with multiple business areas to ensure accurate cost of care targets
- Perform and/or direct complex research to meet corporate cost targets
- Prepare and present cost of care data analysis
- Develop and maintain the provider reimbursement policies
- Manage special projects and initiatives
Requirements
What you’ll need- Requires a BA/BS degree in a related field
- Minimum of 7 years reimbursement experience including performing detailed financial modeling and economic analyses
- CPC - Certified Professional Coder strongly preferred
- MBA or other equivalent advanced degree strongly preferred
- Strong behavioral health background preferred
- Strong critical thinking and analytical skills
- Understanding of pricing methodologies preferred
- Strong written and verbal communications
Benefits
Comp & perks- Paid Time Off
- Medical benefits
- Dental benefits
- Vision benefits
- Short and long term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
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Hard Skills & Tools
financial modelingeconomic analysescoding conventionsbilling rulesreimbursement policiescost of care analysispolicy developmentadjudication of claimsbehavioral health standardspricing methodologies
Soft Skills
critical thinkinganalytical skillswritten communicationverbal communication
Certifications
CPC - Certified Professional CoderMBA