<p>BWC's core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC's seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.</p> <p>What You'll Be Doing:</p> <ul> <li>Independently manages Ambulatory Surgery Center (ASC) or other assigned fee schedules , IPPS, OPPS, PPMS) payment program development & maintenance taking into to account relevant National (i.e., Medicare) and private payer's methodologies. </li><li>Plans, directs, develops & implements relevant medical and reimbursement policies in order to maintain an accurate, efficient, effective, and appropriate ASC reimbursement methodology. </li><li>Monitors & analyzes operations, systems & procedures to ascertain appropriate improvements & feasibility & or impact of assigned fee schedule reimbursement system on administrative functions. </li><li>Execute MCO and provider trainings to facilitate appropriate billing and administration of the assigned fee schedule. </li><li>Serve as the lead responder on inquiries and/or reimbursement approval requests submitted to the Medical Policy mailbox for the ASC reimbursement methodology or other assigned fee schedule. </li></ul> <p>To Qualify, You Must Clearly Demonstrate:</p> <p>Required Experience and/or Education:</p> <p>Completion of graduate core program in health care administration AND 12 months experience in medical policy development for medical provider or insurance company.</p> <p>Or completion of undergraduate program core coursework in pre-medicine, allied medical field, nursing or related field of study AND 12 months practical experience in health care field AND 12 months experience in writing medical policies & procedures for medical provider or insurance company.</p> <p>Or certified medical coder in current procedural terminology (CPT) hospital coding, or current ICD coding system AND 12 months experience in writing medical policies & procedures for medical provider or insurance company AND 12 months practical experience in health care field.</p> <ul> <li>THE 12 MONTHS EXPERIENCE WRITING MEDICAL POLICIES & PROCEDURES IS REQUIRED FOR EACH SECTION FOR THE ABOVE MINIMUM QUALIFCATIONS. YOU MUST HAVE THIS IN ADDITION TO THE OTHER MINIMUM QUALIFICATIONS IN THE SECTION * </li></ul> <p>MAJOR WORKER CHARACTERISTICS:</p> <p>Knowledge of medical/rehabilitation services; health care coverage & reimbursement techniques; health care</p> <p>administration; cost containment measures; statistical analysis; workers' compensation medical policies & insurance</p> <p>industry standards<em>; supervisory principles/techniques</em>. Skill in operation of personal computer*. Ability to understand</p> <p>somewhat abstract field of study (i.e., health care); write & edit technical manuals & instructions; create complex reports</p> <p>using computer software; gather, collate & classify information about data, people or things.</p> <p>(*)Developed after employment.</p>