Manager of Coding & Reimbursement (work remotely from home) #2021-2656
Society for Cardiovascular Angiography and Interventions Foundation
Location: Washington DC
Type: Full Time
Internal Number: 2021-2656
Manager of Coding & Reimbursement
As the Manager of Coding & Reimbursement for the Society for Cardiovascular Angiography and Interventions (SCAI), you will develop strategy for the American Medical Association’s RBRVS Update Committee (RUC), Current Procedural Terminology (CPT) Editorial Panel, and House of Delegates (HOD) – attending meetings and developing relationships with other medical societies to advance SCAI’s position on key issues. You will report to SCAI’s Vice President, Government Relations and work on a team of three. Focusing on reimbursement issues of vital importance to our members, you will ensure that members are well-informed and feel well-supported about the impacts of pending developments in regulatory and legislative policy. You will serve as the lead staff member on the CPT and RUC workgroups of our Government Relations Committee, managing agendas and serving as an active participant in committee meetings.
We represent more than 5,200 members across 75 countries. Interventional cardiology is an interesting, important, and constantly changing field where you will be working with world-renowned experts. We transform life-saving innovation into life-saving action by providing cutting-edge, high-quality education for interventionalists and their teams. Our mission is to lead the global interventional cardiovascular community through education, advocacy, research, and quality patient care. Your efforts will ensure that patients have every opportunity to receive quality cardiovascular care, addressing one of the most important health issues in America.
In the United States, about 40,000 newborns are born with congenital heart defects every year. More than 2 million infants, children, adolescents, and adults are living with congenital heart defects. There are approximately 3 million cardiovascular interventions performed annually in individuals of all ages. Our mission is to lead the global interventional cardiovascular community through education, advocacy, research, and quality patient care. Focus areas for SCAI include establishing standards and guidelines for all aspects of cardiac catheterization and angiography, training, credentialing, safety, and quality assurance for cardiovascular procedures.
Develop and implement a proactive agenda of activities related to SCAI’s policy goals.
Advocate for relevant healthcare policy topics (e.g., utilization issues, coverage process, CPT) before the Centers for Medicare & Medicaid Services (CMS), Food and Drug Administration (FDA), and other federal agencies. Analyze and draft the association’s response to rulemaking; draft comment letters, fact sheets, talking points, and informational articles.
Serve as representative to the CPT, RUC, and HOD. Advocate for favorable national physician payment policies including securing reimbursement and coverage for new and emerging procedures.
Cultivate issue-based and strategic stakeholder groups/coalitions to support comment letters and position statements.
Manage strategic review of insurer activities, including communications with the major national insurance companies. Serve as SCAI’s representative to all insurance carriers; large employers; local, city, county, and federal governments; referring physicians; hospitals. Review and implement multiple local and national payor managed care contracts including capitation, discounted fee, and other fee arrangements to support new revenue streams. Guide corporate partners through the process of establishing appropriate and fair national reimbursement for new technologies. Guide physician practices in establishing processes to enhance revenue generation.
Monitor policy developments on a national level among federal and other medical organizations by networking with others, reviewing key literature, and attending pertinent meetings.
Oversee the development of committee and workgroup agendas to assure productive meetings and discussions on timely topics and activities that result in proactive recommendations for consideration by the board of trustees.
Assist the VP with the development and monitoring of reasonable budgets, financial transactions, and reporting for assigned area per SCAI policies and standard operating procedures.
Conduct statistical analysis and interpreted significance for members of Medicare utilization trends to forecast, report, and support or resolve the economic impact of various recommendations made by the Medicare Payment Advisory Commission (MedPAC), the HOP (Hospital Outpatient Payment) Panel, the Practicing Physician's Advisory Council (PPAC), and other CMS panels and rulings.
Five or more years of experience supporting a medical society.
Knowledge of RUC and CPT processes.
Thorough knowledge of all aspects of physician payment and healthcare-related agencies.
Knowledge of CPT, ICD-10-CM diagnosis coding, and Healthcare Common Procedure Coding System (HCPCS) preferred.
Proven experience with CPT procedure codes and favorable physician payment rates, RVUs, bundled payment programs, inpatient prospective payment systems, outpatient prospective payment system, and physician fee schedules.
Relevant certifications such as CIRCC, CPC, or CGSCI are a plus, but not required.
Experience with statistical analysis.
Collaborative. You will be working with a wide range of external stakeholders and internally across the organization. This requires a flexible style that both complements the efforts and supports the needs of others.
Detail-oriented. You are detail-oriented, but you can also see the big picture and understand how the details relate to the overall mission of the organization.
Flexible and capable. You manage changing priorities without difficulty and get the job done. You do whatever it takes. You are comfortable working in grey areas.
Politically astute. You can understand, respect, and appreciate the challenges of the industry and the ongoing, evolving needs of members. You represent yourself and your organization as polished, credible, and knowledgeable.
Rapport builder. In this position, you will have many stakeholders with varying goals and needs. You establish credibility easily and are quickly seen as the go-to person. You earn trust by your actions and faithfully keep your promises.
Resourceful with great follow through. Whether it is something that requires a quick turnaround or a long-term project with many steps, you take full responsibility from start to finish. When you say you will get back with someone, you do.
Responsive. You hear what stakeholders need and take care of it, or let them know if you can’t. You respond in a timely, effective manner to staff and/or member requests. Internal and external stakeholders respect you for your knowledge and abilities and find you both approachable and responsive.
Service driven. You like to take care of people and help make their work easier. You take the initiative and you work hard to make a difference for others. You are committed to providing a high level of service while remaining aligned to the organizational mission.
What’s Attractive to the Right Candidate?
You will lead several member committees, including RUC and CPT panels.
Your work will save lives. The issues we focus on are interesting and the doctors, scientists, and researchers we work with are committed to ensuring there is a strong pipeline to deal with the wide range of cardiovascular issues facing every American.
SCAI is an exciting and busy environment where you will learn and grow your career. You will be working with smart, collaborative, energetic, hard-working people who are committed to their work and delivering a solid work product.
You will be reporting to an experienced government relations executive who believes in building strong teams around individual strengths. Your opinion will be valued and you will have the opportunity to explore your interests.
As the leading medical society for interventional cardiology professionals, we have experienced tremendous growth over the past 10 years.
We offer highly competitive compensation and benefits that include health, dental, and vision insurance; tuition reimbursement; vacation and holiday pay; retirement plan with employer contribution; short-term and long-term disability insurance; and more.
Simply email your resume to Aileen Hedden at [email protected] with “SCAI – Manager of Coding and Reimbursement #2021-2656 ASAE” as the subject of the email. Please include your resume as a Word or PDF attachment to the email and paste your cover letter in the body of your email.
Please note: our practice is to not disclose the salary ranges our clients would consider. Any salary information included in this posting was estimated without our input.
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