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Medical Policy Coordinator at Blue Cross and Blue Shield of North Carolina - ApplyBlast

Medical Policy Coordinator

Blue Cross and Blue Shield of North Carolina

1 day ago

4.0 on Glassdoor

Remote

Full Time

Medior

0 applicants

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About this role

The Medical Policy Coordinator develops and maintains medical and dental policies to guide coverage for new technologies, procedures, and clinical codes. The role involves coordinating internal and external policy reviews, analyzing clinical and claims data, and serving as a subject matter expert on coding, coverage, and reimbursement. This position supports regulatory compliance, policy implementation, and cross-functional collaboration to enhance healthcare delivery and operational efficiency.

Responsibilities

Develop and update medical and dental policies based on clinical evidence and regulatory requirements
Analyze claims data and utilization patterns to evaluate policy performance and drive improvements
Coordinate internal and external reviews of corporate policies to ensure regulatory compliance

Skills

Qualifications

Registered NurseLicensed Practical NurseAAPC Certified Professional Coder

About Blue Cross and Blue Shield of North Carolina

bluecrossnc.com

Headquarters

Durham, North Carolina, United States

Company Size

5001-10000 employees

Founded

1933

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Blue Cross NC makes health insurance easy. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. Better care starts here.