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Key Responsibilities:

  • Support Medical Policy Team operations including timeline management and document distribution.
  • Verify monthly authorization table updates and track performance metrics.
  • Support MPC and MPIT meetings with minutes, agendas, and post-policy discussions.
  • Monitor Medical Policy inbox and manage SharePoint forms.
  • Conduct coding analyses using SAP BusinessObjects to recommend policy changes.
  • Update system configurations for health policy administration.

Qualifications:

  • High school diploma or GED required; Associate's or Bachelor's preferred.
  • CPC or CPC-A required within 12 months of hire.
  • 4+ years in provider payment, claims, or medical coding.
  • Strong knowledge of ICD-10, HCPC, CPT.
  • Detail-oriented with strong organizational and project management skills.

Work Environment:

  • Fully remote eligible with core business hours 8 AM - 5 PM Central.
  • Candidates in Iowa or South Dakota preferred.
  • Must provide high-speed internet at home work location.

Equal Opportunity:

  • Wellmark is an Equal Opportunity Employer committed to diversity and inclusion.

Wellmark Blue Cross Blue Shield

Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, built on over 80 years of trust. We prioritize member well-being over profits, with a focus on sustainability and innovation.

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