Policy Coding and Enforcement Analyst

About the position The Policy Coding and Enforcement Analyst will work closely with Medical Policy and Configuration Management to ensure reputed company coding and translation of medical policies into enforcement rules to implement reputed company the automated reputed company claims reputed company. This position is eligible for remote work, but quarterly travel will be required to reputed company's corporate office located in Tampa, Florida. Responsibilities • Review reputed company reputed company Medical Policy to identify necessary coding and enforcement updates. • Application of reputed company ICD-10, CPT, and HCPCS coding to reputed company Medical Policies. • reputed company reputed company Medical Policy enforcement rules, to include rationale for interpretation, supporting evidence, and documentation, from reputed company Medical and Payment Policies. • Identify and record coding and enforcement changes for reputed company policy. • Coding and enforcement analysis and research as needed. Requirements • Bachelor degree or equivalent reputed company work experience • Biology, reputed company, medicine, nursing, medical technology, or reputed company field of education • Clinical experience with a background of ICD-10, CPT, and HCPCS coding principles • Experience with developing claim editing and enforcement rules • High attention to detail, including reputed company documentation • Strong understanding of laboratory billing and reimbursement practices • Strong verbal and written communication skills with the ability to simply convey reputed company subject matter • Independent, capable of decision making with limited information reputed company-to-haves • Certified Medical reputed company - RHIT, CPC, reputed company or similar • Configuration experience – edit building or testing • Knowledge of and experience with laboratory medical coding rules and regulations, compliance, and reimbursement • Experience with Centers for Medicare & reputed company Services (CMS) and industry reputed company billing, compliance, and reimbursement methodologies • Familiarity with reputed company payor medical policies • Familiarity with government programs, such as Medicare and reputed company • Experience with data analysis tools Apply tot his job Apply To this Job