Physician Liason - Advanced Coding Specialist

on Dec 10 18:21:46 EST 2007

POSITION SUMMARY:


We are currently seeking a Physician Liason - Advanced Coding Specialist to support the company’s Medical Directors in researching and ensuring that all client payment policies are accurate, up-to-date and complete. This individual will support the Medical Directors with client presentations, researches client questions, and provides timely, accurate responses. This individual should be diplomatic with strong communication and organizational skills and one who is able to effectively problem solve.

 

MAJOR DUTIES AND RESPONSIBILITIES:

 Identifies changes needed to client policies to maintain up-to-date and accurate medical payment policies. Reviews all documents and coordinates reviews with the Medical Directors.Participates in monthly/quarterly client policy meetings:Reviews clients payment policies for accuracyCompletes reviews on a timely basis Clearly understands and articulates medical policies Presents the policies for review and acceptance by the client Provides direction on client understanding of medical policiesCreates value for the client with ad hoc data analysis: Identifies a need or potential for data evaluation Creates report request Authors the analysis of the dataAdds value to Medical Policy and client teams: Participates on Medical Policy and client teams Provides support for Research Analysts Offers benefit of knowledge and experience proactivelyCommunicates effectively with various members of the client team (internal as well as external).

 

REQUIRED SKILLS (2 or more): Professional coder certification (CPC or CCS-P) with broad clinical expertise LPN or RN with medical coding knowledge Well-rounded coder with experience in multiple specialtiesExperience in Health plans, Managed Care or Health Care insurance company/Payers. Prior experience in developing medical payment policy edits Experience in claims adjudication or utilization review working for a managed care or healthcare insurance company Experience as a coding instructor is a plus.Working knowledge of Microsoft Excel, Word and PowerPoint Strong communication, and presentation skills.Effective problem skills resolution.




iHealth Technologies  offers a comprehensive benefits package including medical and dental coverage, 401(k) Plan, Profit sharing, vacation, paid holidays

iHealth Technologies supports a diverse workforce and is an Equal Opportunity Employer, M/F/D/V Invest in your career and join a growing Healthcare service and solution leader.