-Work on ICD-10 update and maintenance project
-Review all LCD and NCD policies maintained by CMS at least once each two-week production cycle to identify Contractor revisions to policies, new policies and retired policies.
-Edit the policy data using the database to assure that accurate and current policy data is delivered to our clients.
-Communicate with onshore stakeholders on a regular basis.
-Research and create policy appropriate code relationships and billing edits as specified in the data requirements for Clients requiring Medicare Data. Create reimbursement related edits like Medical necessity, Modifiers, frequency, POS etc. based on policy language and interpretation.
-Develop complex coding/clinical relationships in an intelligent database, maintain approx. 3500 LCD/NCD policies in bi-weekly production cycle.
-Work on Medicaid/PQRS/other value add projects as required Strong clinical acumen and analytical abilities
-Excellent communication skills
-Tech savvy with good MS office skills
Skill set Required:
a. Graduates (BAMS,BHMS,BPH, B.Sc. or equivalent) with coding certification(must) like CPC/CPC-H, CCS/CCS-P from AAPC/AHIMA or equivalent
b. 2-3 years of experience in medical Coding, Claims Reimbursement, Denial management