What are the responsibilities and job description for the Supervisor, Coding Payment Integrity position at Medica?
Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.
We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.
Medica's Supervisor, Coding Payment Integrity leads teams responsible for resolving complex coding and claim issues, ensuring timely, accurate outcomes for Medica members and providers. This role provides day‑to‑day oversight of the coding team, including managing workflow, monitoring inventory, and assigning work, while driving strong team performance and operational efficiency. The supervisor partners closely with internal teams, leadership, and vendor partners to identify trends, resolve root causes, and improve processes, with a strong focus on coaching, training, and developing credentialed coders. Performs other duties assigned.
Key Accountabilities
Escalated Issue Resolution & Analysis
- Oversee and resolve complex and escalated claim and coding issues
- Interpret provider contracts, policies, and procedures to ensure accurate claim decisions
- Identify trends, root causes, and system or process gaps; drive corrective actions
- Communicate clearly with providers, members, and internal partners
- Document issues and resolutions using required systems and tools
People Leadership
- Lead, coach, and develop Coding Analysts.
- Manage performance through goal setting, feedback, and regular check-ins
- Oversee staffing, training, onboarding, and scheduling
- Foster a positive, accountable, and collaborative team environment
Project & Cross-Functional Work
- Lead operational improvement efforts and special claims projects
- Partner with internal teams, providers, and vendors to resolve issues
- Track progress, share updates with stakeholders, and support company initiatives
Required Qualifications
- Bachelor’s degree or equivalent experience
- 5 years of work experience beyond degree
- 2 years of leadership experience
- Active medical coding certification (e.g., AHIMA, AAPC or equivalent)
Required Qualifications
- Prior experience supervising, coaching, or leading coding staff
- Experience with Optum products and platforms (e.g., Encoder Pro, CES)
- Experience with Health Rules
- Experience working with coding editors and claim editing tools
- Background supporting operational improvements or coding quality initiatives
- Strong communication, organization, and decision‑making skills.
This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, M, Madison, WI, Omaha, NE, and St. Louis, MO.
The full salary grade for this position is $62,700 - $107,500. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $62,700 - $94,080. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.
Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.
We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
Salary : $62,700 - $107,500