Supervisor, Coding Payment Integrity

Medica • St. Louis, MO

12h • Hybrid

About The Position

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.

Requirements

• 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)

Nice To Haves

• 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.

Responsibilities

• 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
• 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
• 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

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 501-1,000 employees