Full-time Remote Coder/Reimbursement Expert Needed

mkaitz

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In this remote position, you will play an integral role in assisting our pharmaceutical, biotechnology and device manufacturer clients with creating targeted reimbursement strategies that maximize patient access at every stage of the product life cycle. Clients count on us to develop strategies that reflect the changing payer environment based on a combination of data and real-world experience.

As a Reimbursement Policy and Insights team member, a typical day might include:
  • Researching coding options for new technologies in development including drug, device, physician services, and diagnoses
  • Writing analyses that summarize and assess steps clients may follow to develop a coding strategy/plan for new, existing or competitive products
  • Identifying codes that may be used in claims database studies
  • Monitoring and notifying clients of new, revised or deleted codes that are released by CMS, the AMA and NCHS
  • Drafting and supporting the submission of coding applications to relevant agencies
  • Educating physician practices, hospitals and other stakeholders in the healthcare provider community about coding and reimbursement issues
  • Serving as an internal and external resource regarding coding and reimbursement information such as payment methodologies, claims processing requirements, and payer coverage guidelines
  • Maintaining current, and developing new, client relationships around reimbursement with a focus on pharmaceuticals
  • Refining and further develop relevance and breadth of existing coding offering
  • Monitoring policies and initiatives that address key issues in the healthcare environment, including pharmaceutical coverage/access and reimbursement, and provide strategic consulting services to clients to support clients’ business priorities
  • Writing proposals to gain new business, and coordinate with cross-company team members for RFP responses and presentations
  • Developing content marketing materials that highlight Xcenda’s understanding of coding and reimbursement
  • Participating in projects and activities related to patient access and health policy

Minimum Requirements
  • Bachelor’s degree
  • Current coding certification such as CPC, COC, CIC, CCA
  • Minimum of 5+ years relevant coding and reimbursement experience
  • Excellent research, writing, presentation and analytical skills
  • Experience and comfort with existing all code sets including CPT, HCPCS, ICD-10, revenue, etc.
  • Understanding Medicare payment policies, particularly related to pharmaceuticals and associated services
  • Experience in a wide range of topics, including coverage, coding, and payment across commercial and public payers,
  • Ability to translate detailed technical information to others with limited experience in coding
  • Ability to travel 15%
Preferred Qualifications:
  • 10+ years relevant experience
  • Master’s degree in public health, health policy, healthcare management or other relevant field
  • Experience/Understanding of drug distribution and specialty pharmacy, and patient support services
  • Practice/hospital management or billing department management experience


Please forward a resume to

Milda Kaitz, CPC, CPC-I, CPMA
AmerisourceBergen
Associate Director, Reimbursement, Policy & Insights
Xcenda, LLC
milda.kaitz@xcenda.com
Work: 650-727.7679
www.xcenda.com

Amanda O’Hora
AmerisourceBergen
Senior Director, Reimbursement, Policy & Insights
Xcenda, LLC
amanda.o’hora@xcenda.com
Work: 704.943.1818
www.xcenda.com
 
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