Policy Design Specialist I

The Policy Design Specialist role is responsible for managing health plan clients and executing monthly project requests. Perform policy configuration maintenance of current medical policies along with implementing new health plan medical policies per client request. Adhere to and remain in alignment with the most up to date healthcare industry medical coding guidelines. Perform data analysis to determine how to accurately apply coding updates and client requested customizations. Execute quality assurance checks to ensure appropriate claim editing recommendations are applied based on client request.