Product Development & Benefit Manager – Minneapolis
- - Design - Plan Design
- Minneapolis , MN, USA
- Full Time
Bind was formed in 2016 by veteran health insurance innovators passionate about making health insurance personal - with the clarity, flexibility and power people deserve.
Want to move mountains?
Bind took the old model of health insurance apart and is rebuilding it - from floor to ceiling, from studs to rafters. We're not iterating a tired design or nudging a change-resistant industry, we're delivering what people want now - clear prices, timely support, personal choice and flexibility and an awesome, intuitive experience.
Where different wins.
Help build different and make a difference. Become a Binder and help us revolutionize health insurance.
Product Development & Benefit Manager – Minneapolis
We are seeking a Product Development & Benefit Managerwithin health insurance plan design to join our growing team. In this position, you will play a key role in enabling the Bind benefit plan by reviewing and analyzing the benefit plan and partnering with Plan Design, Clinical and Operations subject matter experts to ensure use and adoption of appropriate coding standards through the development, implementation and administration of the Bind benefit coverage specifications.
- Collaborate with the Plan Design Architect to provide subject matter expertise for claim processing, ensuring appropriate interpretation and application of medical coding standards in setup and configuration of claim adjudication engine
- Ensure all appropriate codes are assigned and sequenced as needed
- Assist in enabling the Bind benefit plans by reviewing and analyzing intent, coding, and configuration
- Ensure adherence to state and federal compliance policies, reimbursement policies and contract requirements
- Facilitate meetings with Account Partners, Clinical, Operations and others to achieve benefit design solutions that meet needs and expectations
- Participate in development and maintenance of code sets across Bind capabilities
- Review Bind benefit plan for accuracy and completeness of codes, ensuring all codes are current and active
- Assist in translation of consumer-friendly medical terms and concepts into the proper clinical codes
- Conduct regular review of benefit plan codes to maintain compliance with standards
- Ensure compliance with member benefit regulations across Bind plan designs (Mental Health Parity, etc.)
- Create and maintain coverage specifications for Bind plan designs
- Partner with Plan Design, Clinical and Operations to develop and maintain program/solution documentation and specifications
- Participate in the process for maintaining codes within the coverage specifications
- Serve as a resource regarding coding questions and interpretation of standards; provide support on use of codes and changes to coding standards as needed
- 5+ years of experience performing coverage review which requires interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies, coding requirements and consideration of relevant clinical information on claims
- 5+ years of medical benefit plan design and/or configuration and medical coding experience
- 5+ years business/operations experience in a health plan environment and familiarity with commercial plan design
- Experience assisting in the plan build/plan configuration of claim adjudication platform
- Working knowledge of HCPCS, CPT, ICD10 CM and PCS, J codes and Rev codes
- Experience in the application of medical and reimbursement policies within the claims adjudication process
- Strong analytical skills
- Clear, concise, engaging and effective written and oral communication
- Bachelor's degree or equivalent years of relevant work experience
- Willingness and ability to be both an individual contributor and a team player
- Ability to influence without direct control
- Proficient in Microsoft Word, Excel, PowerPoint, etc.
- Accurate and precise attention to detail
- Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA license
- Health Insurance/Heath Care industry experience strongly preferred
- Agile, ready to change direction on the fly
- Startup experience
- Working in an ambiguous, fast-paced environment
What We're Offering
- Chance to join a new tech start-up aiming to fix the healthcare industry
- Empowerment to shape new solutions disrupting healthcare while providing benefits and choice to its members
- Flexible work-from-home schedule to support work-life balance
- Opportunity to work with people who are motivated to go to work every day and make a difference
- Equity, competitive pay, generous PTO, and the opportunity to be a part of a new health insurance plan powered by the consumer, you!
Diversity creates a healthier atmosphere. Bind is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Bind is a drug-free workplace.
Bind sponsors H-1B visas for current H-1B visa holders on a limited basis, other visa sponsorship not available.