CAREERS

Medical Director Assistant

• Identifies changes needed to client policies to maintain up-to-date and accurate medical payment policies.
• Reviews all documents and coordinates reviews with the Medical Directors
• Participates in monthly/quarterly client policy meetings:
  • Reviews clients payment policies for accuracy
  • Completes reviews on a timely basis
  • Clearly understands and articulates medical policies
  • Presents the policies for review and acceptance by the client
  • Provides direction on client understanding of medical policies
• Creates value for the clients with ad hoc data analysis
  • Identifies a need or potential for data evaluation
  • Creates report request
  • Authors the analysis of data
• Adds value to Medical Policy and client teams:
  • Participates on Medical Policy and client teams
  • Provides Support for Research Analysts
  • Offers benefit of knowledge and experience proactively
• Communicates effectively with various members of the client team (internal as well as external)

• Maintain an up-to-date knowledgebase on industry and iHT content, best practices, applications, procedures, and policies.
• Other duties, tasks and responsibilities as assigned.

• Professional coder certification (CPC or CCS-P) with broad clinical expertise or LPN/RN with medical coding knowledge
• Experience in Health plans, Managed Care or Health Care insurance company
• Prior experience in developing medical payment policy edits
• Experience in claims adjudication or utilization review working for a managed care or healthcare insurance company
• Experience as a coding instructor is a plus
• Working knowledge of Microsoft Excel, Word and Powerpoint
• Strong communication and presentation skills
• Effective problem solving skills
• Strong Knowledge of CMS guidelines

• Education/Certification: Professional coder certification (CPC,CPC-H, CPC-P or CCS-P) or LPN or RN with medical coding knowledge.
• Health plans, Managed Care or Health Care insurance company experience
• Working knowledge of Microsoft Excel, Word and Powerpoint

• Must be able to sit for lengthy periods and work with a computer to accomplish many tasks
• Must be able to speak clearly
• Must have normal comprehension and ability to use the English language for business communication both written and verbal
• Must be able to use a computer keyboard
• Travel Required (25%)

• No direct reports
• Internal: Medical Directors, Client Services Managers, Client Service VP, Senior Research Analysts, Client Business Support Analysts, Configuration Analysts,
• External: Client Medical Directors, Client Payment Policy personnel