We are looking for a skilled Clinical Policy Coding Administrator to join our team on a contract basis. This position is based in Mountlake Terrace, Washington, and offers an excellent opportunity to contribute to the health insurance industry. The selected candidate will play a key role in analyzing medical policies, ensuring accurate coding, and supporting cross-functional collaboration to enhance policy implementation and claims processing.<br><br>Responsibilities:<br>• Analyze and interpret medical policies to identify and update accurate procedure and diagnosis codes.<br>• Collaborate with cross-functional teams to ensure seamless implementation of medical policies and utilization management guidelines.<br>• Provide coding expertise to support decision-making processes related to claims, reimbursement, and product configuration.<br>• Conduct thorough research and data analysis to evaluate the effectiveness of medical policy implementation.<br>• Facilitate meetings and discussions with stakeholders to address coding edits and mitigate downstream impacts.<br>• Ensure coding updates align with medical necessity and regulatory requirements.<br>• Act as a subject matter expert in coding-related matters for various departments.<br>• Address cross-functional requests with detailed assessments to enhance consistency in claims processing.<br>• Support the development of medical policies by providing accurate coding recommendations.<br>• Maintain compliance with industry standards and company-specific coding practices.
