Coding And Reimbursement Specialist

Overview

• Provide expert-level technical coding guidance and support for urology coding and reimbursement projects.
• Assist in triaging coding inquiries, conducting research, and drafting internal summaries for coding-related activities.
• Support preparation and follow-up for CPT and RUC-related activities, including code change applications and survey materials.
• Analyze large data sets, including RUC survey data, to inform coding strategies and recommendations.
• Provide strategic advice and technical support for insurance coverage, payment issues, and payer policies.
• Maintain and coordinate follow-up for industry consulting program trackers and payment policy inbox.
• Offer practice management support for coding, billing, and claims inquiries during meetings or upon request.
• Ensure continuity across recurring coding and reimbursement activities during high-volume periods.

Key Responsibilities & Duties

• Respond to routine coding and reimbursement inquiries from members and stakeholders.
• Track and analyze coding issues and trends raised by members or stakeholders.
• Support preparation of materials for CPT and RUC processes, including surveys and recommendations.
• Analyze large data sets to inform coding and reimbursement strategies.
• Provide technical guidance on urology-related codes and payer policies.
• Coordinate follow-up for industry consulting program trackers and payment policy inbox.
• Assist with coding-related administrative tasks and meeting preparation.
• Maintain confidentiality and adhere to organizational policies and standards.

Job Requirements

• Bachelor of Arts degree required, with strong knowledge in medical coding and reimbursement.
• Minimum of 3 years of experience in medical coding; 10 years preferred.
• CPC certification required; experience in urology coding strongly preferred.
• Knowledge of AMA RUC and CPT processes essential.
• Proficiency in Microsoft Office suite, particularly Excel, and ability to adapt to technology ecosystems.
• Demonstrated ability to analyze large data sets and provide actionable insights.
• Strong organizational skills with attention to detail and confidentiality.
• Experience with specialty societies, payer policies, and MAC LCDs preferred.