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Medical Coding Clinical Analyst - Tampa

Company: AVALON HEALTHCARE SOLUTIONS
Location: Tampa
Posted on: March 17, 2019

Job Description:

Responsibilities Responsibilities of the Medical Coding Clinical Analyst Position: Translate lab medical policy narrative into appropriate ICD, CPT, and/or HCPCS codes to facilitate prior authorization activity and/or appropriate system adjudication.Provide clinical and coding expertise in reconciling differences between Avalon and client lab medical policies.Liaise with various Operations team members to ensure that business rules mirror policy intent.Contribute content to facilitate communication with and education of the provider network and client base regarding lab medical policy.Identify lab claims system coding issues and assist in the formulation of system efficiency recommendations to ensure exceptions reduction through accurate coding and clinical appropriateness.Participate in the analysis of lab claim coding trends. Identify potential root causes of trends, and recommend changes in methods, procedures, and policies in order to improve quality and consistency with industry standard coding guidelines. Qualifications Qualifications of the Medical Coding Clinical Analyst Position: At least five years of medical or lab coding experience with strong knowledge of and experience with CMS coding and reimbursement rules and industry standard claims editing software.Active RN license.Previous employment by a health plan or lab provider in which knowledge of diagnostic and procedural coding practices was frequently accessed.Experience with Centers for Medicare & Medicaid Services (CMS) and industry standard billing, compliance, and reimbursement methodologies.Knowledge of and experience with laboratory medical coding rules and regulations, compliance, reimbursement, bundling issues.Certified Coding Specialist, Physician-Based (C

Keywords: AVALON HEALTHCARE SOLUTIONS, Tampa , Medical Coding Clinical Analyst - Tampa, Healthcare , Tampa, Florida

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