Payment Policy and Medical Coding Associate - Contract-to-Hire
Job Description:
We are seeking a detail-oriented and knowledgeable Payment Policy and Medical Associate. The primary responsibilities include monitoring payer policies, code changes, and guidelines, contributing to and maintaining coding and billing resources and courses, and assisting members with their coding and billing needs. This role may include guiding proper code selection, understanding reimbursement policies, and troubleshooting claim denials.
Key Responsibilities:
- Stay informed about code changes, coding edits, third-party payer coverage, and Medicare/Medicaid policies.
- Monitor industry discussions regarding ICD-11-CM implementation in the United States.
- Assist members with issues related to procedural and diagnostic coding systems (ICD-10-CM, CPT, CDT) and their impact on reimbursement.
- Develop and maintain coding and reimbursement resources on the company website.
- Monitor state insurance codes, payer websites, and national health policy changes that may impact members.
- Prepare comments to CMS and other agencies regarding policy changes.
- Serve as the primary liaison for coding and reimbursement inquiries.
- Support coding and billing courses, workshops, and continuing education programs.
- Provide technical and staff support to relevant committees and handle logistics for meetings and projects.
Qualifications:
- Strong verbal and written communication skills.
- Ability to work independently and collaboratively.
- Expertise in coding and billing systems (CPT, CDT, ICD-10-CM) and their relation to physician reimbursement.
- Familiarity with medical and dental terminology and frequently utilized procedures.
- Experience with policy research, data analysis, and electronic health records.
- Understanding of government and private payer policies.
- Excellent organizational, time management, and project management skills.
- Basic understanding of marketing concepts.
- Ability to lift up to 50 lbs.
- Ability to travel up to 10%.
Key Accountabilities:
- Develop and maintain coding and reimbursement resources.
- Respond to member inquiries and track coding and reimbursement trends.
- Notify members of changes in coding and health policy.
- Assist with coding course development and implementation.
- Support committee meetings and assist in logistics and content development.
- Monitor relevant regulatory and coding activities at the national level.
- Participate in national conferences and meetings as required.
This role is ideal for someone with a strong background in medical or dental coding, policy analysis, and a desire to support the healthcare community through coding and reimbursement guidance.
