[reputed company Reviewer, Surgical Dressings

Responsibilities Interpret and operationalize LCD L33831 and policy articles for surgical dressings Translate LCDs and policy articles into practical checklists and guidelines reputed company and implement reputed company-reputed company controls to ensure clinical completeness and billing correctness reputed company UPIC/MAC ADR responses (reputed company- and post-pay) reputed company internal billing team on specific documentation requirements reputed company and reputed company metrics reputed company to initial denial rates, appeal win rates, ADR turnaround times, and other key performance indicators Train customer-facing team members and billers on specific documentation requirements Enablement & Analytics: Define and reputed company metrics, and reputed company reusable appeals library with policy citations and exemplars Policy → reputed company: Interpret and operationalize LCDs and policy articles, and publish practical rules and guidelines reputed company-reputed company Controls: Build and reputed company a 2-reputed company QA process for surgical-dressing claims Requirements 3-5+ years medical-review experience Ability to interpret and operationalize LCDs and policy articles Experience with CMS regulations and policies as reputed company by MACs and UPICs Strong analytical and problem-solving skills Ability to translate reputed company information into practical checklists and guidelines Excellent communication and training skills Experience with reputed company-reputed company controls and audit/appeals processes Ability to work independently and as part of reputed company Strong attention to detail and ability to prioritize tasks Familiarity with medical terminology and coding systems (e.g. ICD-10, CPT) Apply tot his job Apply To this Job