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Medical Affairs Coordinator - West Columbia, United States - Spectraforce Technologies
Description
Job Title:
Medical Affairs Coordinator
Location:
Columbia, SC 29203
. (Remote)
Duration: 12 months assignment with possible conversion
Shift:
Mon - Fri, 9am to 5pm EST. May require additional time/effort when needed
Payrate:
$38/hr
Note: 2-3 rounds of interviews
Summary:
Ensures that the Local Coverage Determination (LCD) process adheres to contract instructions.
Creates, implements, and maintains educational tools to help providers reduce the submission of claims for non-covered services and reduce the claims payment error rate.
The error rate is a factor in awarding and renewing Medicare/other contracts.Responsibilities:
50% Provides clinical expertise, research, and judgment to develop Local Coverage Determinations(LCDS) under the direction of medical director. Maintains LCDS once developed.
35% Educates providers and internal customers on LCDS. Communicates with other interdepartmental staff in appropriate coding and reimbursement guidelines to ensure coordination and compliance.
15% Provides clinical input for internal requests. Serves as reviewer to determine inter-rater reliability.
Required Education:
Bachelor's degree - Nursing or other health related field. OR, Associate's degree in Nursing with an active RN license.
Required Work Experience:
5 years clinical experience in medical insurance, managed care, case management, or claims management, or a combination of these areas.
Required License and Certificate:
An active, unrestricted RN license from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).
Preferred Education:
Bachelor's degree- Nursing.
Preferred Work Experience: 7 years-clinical experience in medical insurance, managed care, case management, or claims management, or a combination of these areas.
Preferred Licenses and Certificates:
HIAA, Loma, and/or ACLI certification
MPH, MHA certifications Languages:
English.
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