Top 3888 Policy analyst Jobs in Scaggsville Md

Payment Policy Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $58,320 - $115,830 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Mid-level
- 401(k)
Remote Case Processing Analyst
GCC Technologies, LLC —Washington, DC
- Remote
- English
- Mid-level
- 3 years
BCBA - Board Certified Behavior Analyst - Hybrid (Growth Opportunities)
Admire ABA —Gaithersburg, MD
- $90 - $120 an hour
- Part-time
- Background check
- Experience working with individuals with developmental disabilities
- HIPAA
- Mileage reimbursement
- Professional development assistance
Quick Apply
Mission Management Support Systems Engineer
Peraton —Fort Meade, MD
- $176,000 - $282,000 a year
- Full-time
- Computer science
- Computer Science
- Master's degree
- Health savings account
- Paid holidays
Senior Payroll Analyst
HMSHost by Avolta —Bethesda, MD
- $70,000 - $83,000 a year
- Full-time
- Hospitality
- Microsoft Excel
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Solutions Architect
RWD Consulting, LLC —Bethesda, MD
- $100,000 - $130,000 a year
- Full-time
- 7 years
- Computer Science
- System design
- Health insurance
- Dental insurance
Quick Apply
AFSIM Analyst
Johns Hopkins Applied Physics Laboratory (APL) —Laurel, MD
- $100,000 - $245,000 a year
- Full-time
- Computer science
- Computer Science
- Mid-level
- Disability insurance
- Health insurance
Policy Lead
QED Systems LLC —Arlington, VA
- $120,000 - $135,000 a year
- Full-time
- 7 years
- Microsoft Outlook
- Office
- AD&D insurance
- Paid holidays
Quick Apply
Senior Asset Manager
Local Initiatives Support Corporation —Washington, DC
- $93,362 - $116,703 a year
- Remote
- 6 years
- Office
- Finance
- Disability insurance
- Health insurance
Quick Apply
Senior LPD Financial Team Lead
ICI Services —Washington, DC
- Full-time
- Master's degree
- Supervising experience
- Bachelor's degree
- AD&D insurance
- Paid holidays
Board Certified Behavior Analyst (BCBA) for Schools | #34815
Ro Health —Rockville, MD
- From $50 an hour
- 8 hour shift
- School experience
- Management
- Up to 50% travel
- Mileage reimbursement
- Health insurance
Quick Apply
15h
Senior AFSIM Analyst
Johns Hopkins Applied Physics Laboratory (APL) —Laurel, MD
- $105,000 - $245,000 a year
- Full-time
- Computer Science
- Engineering
- Java
- Disability insurance
- Health insurance
Combat System Analyst
Johns Hopkins Applied Physics Laboratory (APL) —Laurel, MD
- $100,000 - $245,000 a year
- Full-time
- Computer Science
- Bachelor of Science
- System design
- Disability insurance
- Health insurance
Submarine Combat System Test and Evaluation Analyst
Johns Hopkins Applied Physics Laboratory (APL) —Laurel, MD
- $100,000 - $245,000 a year
- Full-time
- Bachelor of Science
- Engineering
- Travel
- Disability insurance
- Health insurance
AFSIM Developer
Johns Hopkins Applied Physics Laboratory (APL) —Laurel, MD
- $100,000 - $245,000 a year
- Full-time
- Computer Science
- Data analysis skills
- 3 years
- Disability insurance
- Health insurance
Senior Knowledge Manager
Novel Applications of Vital Information, Inc. —McLean, VA
- $120,000 - $162,000 a year
- Full-time
- Background check
- 18 years or older
- Bachelor of Science
- Travel reimbursement
- Paid holidays
Quick Apply
Financial Services Budget Execution Analyst
Reithorp Solutions LLC —McLean, VA
- $155,000 - $186,000 a year
- Full-time
- Office
- Finance
- Master's degree
- Health insurance
- Dental insurance
Quick Apply
Marketing and Communications Data Analyst (Top Secret cleared)
ICF —Washington, DC
- $67,063 - $114,008 a year
- Full-time
- Marketing
- Mid-level
- 3 years
Data Architect
WSSC Water —Laurel, MD
- $135,814 - $231,251 a year
- Full-time
- System design
- HIPAA
- Office
Senior Systems Design Engineer / Analyst
Johns Hopkins Applied Physics Laboratory (APL) —Laurel, MD
- $100,000 - $245,000 a year
- Full-time
- 5 years
- System design
- Office
- Disability insurance
- Health insurance

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policy analyst jobs near scaggsville md

Payment Policy Analyst (Remote)

CareFirst BlueCross BlueShield -
Baltimore, MD

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Job Details

Full-time
$58,320 - $115,830 a year

Benefits

401(k)

Qualifications

Managed care
Health insurance policy knowledge
Policy analysis
Internal employee customer service

Full Job Description

Resp & Qualifications

PURPOSE:
The Payment Policy Analyst will research, develop, and coordinate the distribution and maintenance of payment policies in support of corporate payment methodologies, provider contracts, claims adjudication rules, and applicable regulatory and industry standards. This role applies analytical skills and subject matter knowledge to evaluate the impact of payment policies and ensure accurate implementation. We are looking for experienced professionals to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.

ESSENTIAL FUNCTIONS:

Performs in-depth research on topics identified as actual or potential payment policies. Evaluates CMS guidance, industry references, peer health plan policies, coding conventions, and other authoritative sources to determine appropriateness for policy development. Assesses and communicates the operational, financial, and provider impact of payment policy decisions.
Writes evidence-based payment policies and operating procedures related to reimbursement methodologies, coding and billing rules, legislative and regulatory mandates, contractual provisions, and corporate payment philosophy to ensure consistent application across all lines of business.
Maintains the Payment Policy Reference Manual (PPRM), including resource files and supporting documentation. Ensures dissemination of payment policies and procedures to implementation teams (e.g., claims, configuration, provider operations) and other appropriate departments. Ensures maintenance and accuracy of online policy content, responds to business inquiries, and provides written clarification of existing and emerging payment policies and trends.

QUALIFICATIONS:

Education Level: Bachelor's Degree in Health Administration, Business, Finance, Nursing or related discipline OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Licenses/Certifications Upon Hire Required:

Certified Coder (CCS or CPC)-AHIMA or AAPC AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS).

Experience: 3 years experience in payment policy, reimbursement policy, claims configuration, billing rules, and/or coding guidelines in a health care or health plan setting.

Preferred Qualifications:

Advanced knowledge of CPT, HCPCS, ICD-10-CM/PCS coding systems and claims reimbursement rules.
Experience in technical writing, reimbursement methodologies, health economics or statistics.

Knowledge, Skills and Abilities (KSAs)

Ability to analyze complex information, make sound decisions, and resolve policy-related issues.
Demonstrated ability to work collaboratively across operational and technical teams.
Strong written and verbal communication skills, including ability to present to internal stakeholders at all levels.
Use of Microsoft Office applications (Excel, PowerPoint, Word).
Working knowledge of medical insurance and managed care principles.
Knowledge of fee schedules, payment methodologies, bundling logic, modifiers, and places of service.
Knowledge of standardized processes for evaluating payment support operations and claims adjudication practices.

Salary Range: $58,320 - $115,830

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Health Services

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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Refine Your Search

policy analyst jobs in scaggsville md

Payment Policy Analyst (Remote)

Remote Case Processing Analyst

BCBA - Board Certified Behavior Analyst - Hybrid (Growth Opportunities)

Mission Management Support Systems Engineer

Senior Payroll Analyst

Solutions Architect

AFSIM Analyst

Policy Lead

Senior Asset Manager

Senior LPD Financial Team Lead

Board Certified Behavior Analyst (BCBA) for Schools | #34815

Senior AFSIM Analyst

Combat System Analyst

Submarine Combat System Test and Evaluation Analyst

AFSIM Developer

Senior Knowledge Manager

Financial Services Budget Execution Analyst

Marketing and Communications Data Analyst (Top Secret cleared)

Data Architect

Senior Systems Design Engineer / Analyst

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