Clinical P&R Support Spec I

Job Description

Job Description

Let’s do great things, together!

About Moda

Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary

The Clinical Policy & Reimbursement Support Specialist I provides assistance and support to the Clinical Policy & Reimbursement team and Claims Manager related to clinical editing vendor. Recommend and coordinate processes to enhance and problem solve new or inconsistent claim payment and coding policies related to clinical editing. This is a FT WFH role.

Pay Range

$22.88 - $25.74 hourly (depending on experience)

• Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position.

https : / / j.brt.mv / jb.do?reqGK=27765791 &refresh=true

Benefits :

Required Skills, Experience & Education :

Primary Functions :

Working Conditions & Contact with Others

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations please direct your questions to Danielle Baker & Kristy Nehler via our humanresources@modahealth.com email.