POSITION: Coding, Reimbursement and Registry Staff Associate
REPORTS TO: Health Policy, Quality, and Reimbursement Manager
The Coding, Reimbursement and Registry Staff Associate, reports to the Health Policy, Quality and Reimbursement Manager and is responsible for developing and maintaining the association’s library of coding and billing resources related to oral and maxillofacial surgery The Coding, Reimbursement and Registry Staff Associate is also the association’s primary coding associate and is responsible for responding to member coding and reimbursement inquiries by providing guidance on proper code selection, coding and billing guidance, and appeal advice.
The Coding, Reimbursement and Registry Staff Associate will serve as part of the registry team and maintain applicable member resources and tools. This requires detail-oriented team member who can capture requirements, plan, execute, and finalize registry projects that ultimately help and improve upon registry goals. The ideal candidate has the key ability to follow a project through from inception to execution, by working with our internal staff, our registry committee and our technology partner. This Staff Associate should have the ability to monitor Medicare, Medicaid, and private payer policies affecting the specialty, including issues related to physician quality improvement measures and activities. This Staff Associate will assist with the development and implementation of quality improvement activities and resources for the specialty as needed.
In addition, the Coding, Reimbursement and Registry Staff Associate assists the Manager with monitoring Correct Coding Initiative (CCI) updates, Medicare’s Medically Unlikely Edits, and any updates made to the medical claim by the National Uniform Claim Committee (NUCC) and the Workgroup for Electronic Data Interchange (WEDI). The Coding, Reimbursement and Registry Staff Associate is responsible for alerting the Manager of changes related to coding and / or reimbursement policies that would impact the specialty of oral and maxillofacial surgery so that proper member notice may be arranged. The Coding, Reimbursement and Registry Staff Associate may also serve as a staff liaison to the ADA’s Code Maintenance Committee, as required and assists the manager and advisors with preparing code proposals and meeting minutes. This position must also stay abreast of initiatives stemming from third-party dental and medical payers including both Medicare and Medicaid and their initiative, including the Accountable Care Act, Medicare incentive programs, and other health reform activities.
The Coding, Reimbursement and Registry Staff Associate is accountable for writing bimonthly articles for our various online and print publications. In addition, the Coding, Reimbursement and Registry Staff Associate is responsible for maintaining and revising the resources available on the appropriate and corresponding sections of the AAOMS web site. This position is also responsible for maintaining the electronic logging of member inquiries in order to identify coding and reimbursement trends.
The Coding, Reimbursement and Registry Staff Associate, provides year-round staff support to the Committee on Health Care Policy, Coding, and Reimbursement (CHCPR); including assistance with coordinating CHCPR member projects, committee meeting logistics, and meeting / conference call agendas and writing reports.
The Coding, Reimbursement and Registry Staff Associate may also handle miscellaneous projects as directed by the Manager and/or the Associate Executive Director of the Practice Management & Government Affairs
Develop and maintain resources to assist the membership with coding and reimbursement
Respond to member inquiries on issues related to coding and reimbursement
Maintain tracking system on coding and reimbursement inquiries for trend analysis
Notify membership of changes in coding and health policy
Provide technical and staff support to the Committee on Healthcare Policy, Coding and Reimbursement
Assist with the implementation of the AAOMS in-person and on-line coding courses and webinars
Assist with the preparation and coordination of new/revised code proposals
Provide support for the Health Policy, Quality and Reimbursement Manager
Serve as primary coding inquiry liaison through phone and email requests
Monitor the NUCC, WEDI, HHS and Correct Coding Initiative activities
Monitor and refresh coding and reimbursement resources page of AAOMS website
Update AAOMS Coding and Reimbursement Library as necessary
Support manager in addressing issues related to data set definitions or measures/metrics.
Assist with research, analytics and registry reporting with respect to quality and outcome measures/metrics. with external stakeholder (e.g., private payer, Centers for Medicare and Medicaid, health systems, etc.) programs.
Coordinate the development, implementation, and update of performance reports and ad hoc projects for the registry.
Prepare training materials (training manuals, FAQs, reference guides) to assist participants with data collection and report interpretation.
Coordinate/assist in the content development and logistics of registry related workshops, meetings, and/or conferences as necessary.
Work closely with the manager to organize regular communication via newsletters, memos, emails and websites to ensure that participants are oriented to the Registry and aware of upcoming changes or need for action.
Participate in national conferences, association meetings and offsite participant recruitment efforts, as appropriate and/or directed.
DETAILED DESCRIPTION OF KEY ACCOUNTABILITIES
Develop and maintain resources to assist with and respond to member coding and reimbursement inquiries
Research information to advise the membership on proper code selection by: reviewing operative and pathology reports, assisting in preventing inappropriate billing practices (unbundling, upcoding, etc.), advising when to use modifiers, and providing general strategies to optimize reimbursement
Respond to member inquiries relating to Medicare and third-party reimbursement including appeals, billing procedures, fraud and abuse and regulatory compliance
Develop standardized responses to frequently asked questions
Develop member products (i.e. Coding papers, Clinical Condition Statements, etc as well as Coding Corner articles) and self-help tools which can be used to educate the membership about proper coding methods
Maintain tracking system for coding and reimbursement inquiries for analysis
Log each call with detailed information (e.g. member’s name, phone, date and time called, question with resolved answer and date)
Analyze calls on a monthly basis, and determine high volume issues. Share information with appropriate parties and use data for customization of Coding Workshops and other membership assistance products
Communicate trends of interest to Committee and staff
Notify membership of changes in coding/reimbursement/health policy
Identify and utilize opportunities to provide education on coding and reimbursement techniques through AAOMS news vehicles, meetings, and network communications
Continually remind membership of established coding products and other AAOMS educational opportunities available
Provide technical and staff support to the Committee on Healthcare and Advocacy
Provide administrative support including agenda preparation, on-site meeting management, follow-up activities such as meeting minutes and related committee requested research
Perform trends analysis and presentation to committee for incorporation in their efforts
Monitor CDT, CPT, HCPCS and ICD-10-CM changes
Monitor directives by HHS, NCVHS, OIG, and CMS
Performs other similar or related duties as requested or assigned by the Health Policy, Quality, and Reimbursement Manager
Strong verbal and written communication skills
Ability to work independently but collaboratively
Ability to handle complex coding and billing issues
Excellent organizational, time and project management skills
Knowledge of Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) coding systems and Internal Classification of Diseases (ICD) coding system
Knowledge of medical and dental terminology and physiology
General knowledge of OMS, medical or dental clinical practice, specific familiarity with frequently utilized procedures
Experience with data analysis, electronic health records, practices management and / or registry solutions.
Knowledge of government and private payor policies
Experience with outcome research, and/or clinical registry projects is a plus.
Familiarity with National Quality Forum, measurement endorsement process, and the overall quality measurement landscape
Must be able to lift up to 50 lbs.
Understanding of basic marketing skills
Internal Number: CRA062119
About American Assoc of Oral & Maxilofacial Surg.
Established in 1918, the American Association of Oral and Maxillofacial Surgeons (AAOMS), the professional organization representing more than 9,000 oral and maxillofacial surgeons in the United States, supports its members' ability to practice their specialty through education, research, and advocacy. AAOMS members comply with rigorous continuing education requirements and submit to periodic office examinations, ensuring the public that all office procedures and personnel meet stringent national standards.
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