Medicare Coverage Analyst

Description

Professional - Nonclinical
Req #: 65307

Summary:
The Medicare Coverage Analyst role interfaces between the research departments and billing process. This role will review each study protocol and informed consent to determine each medical service the patient will receive to develop the Medicare Coverage Analysis (MCA).

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education: Associate or Bachelor's Degree or one year equivalent and related work experience in finance/coding/billing or billing for services rendered to a patent in a clinical trial in the hospital setting or healthcare industry required.
2. License/Certifications: Applicable professional certification through AHIMA (CCA) or AAPC (CPC A, COC-A) preferred. Must obtain professional credential within one year of start date. Obtain Epic Proficiency for Research Billing within six months of start date.
3. Experience: See Education. EPIC HB/PB preferred.
4. Additional Skills/Requirements Required: NA
5. Additional Skills/Requirements Preferred: Microsoft Office skills. Knowledge of revenue cycle processes and hospital/ medical billing. Understanding of components of electronic medical record. Knowledge of code data sets to include CPT, HCPCS, ICD 10, Revenue codes, Value Codes and Conditions codes. Knowledge of NCCI edits, and Medicare LCD/NCDs as well as Medicare Manuals

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Additional Information

If you have questions about this role, please contact alyssa.lewis@mainehealth.org